Cryoanalgesia

Abstract

Does freezing of sensory nerves in the groin reduce pain after hernia repair? Extreme cold (-60 degrees C) was applied in a double-blind, randomized study. No difference in pain scores was found. Sensory disturbances were seen in treatment and control patients. Freezing cannot be recommended for pain relief after hernia repair.

Cryoanalgesia for postsurgical pain relief in adults: A systematic review and meta-analysis

“…The characteristics of included studies, including the study population, intervention, and comparator, are reported in Table 1 . Of the 24 trials, 20 were for thoracic surgeries, two for herniorrhaphy [ 19 , 20 ], one for nephrectomy [ 21 ] and one for tonsillectomy [ 22 ]. Interventions included cryoanalgesia alone [ 23 ], cryoanalgesia with opioid analgesia [ [19] , [20] , [21] , [22] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] ], or cryoanalgesia with epidural and opioid analgesia [ 41 , 42 ].…”

“…Cryoanalgesia was administered intraoperatively in all studies. Comparators included epidural analgesia [ [33] , [34] , [35] , [36] , [40] , [41] , [42] ], intercostal nerve blocks [ [37] , [38] , [39] ], opioid analgesia only [ [19] , [20] , [21] , [22] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ], nonopioid analgesia only [ 23 ], and non-divided intercostal muscle flap [ 24 ]. Only one study reported using a sham cryoanalgesia treatment in the comparator arm [ 19 ].…”

“…Comparators included epidural analgesia [ [33] , [34] , [35] , [36] , [40] , [41] , [42] ], intercostal nerve blocks [ [37] , [38] , [39] ], opioid analgesia only [ [19] , [20] , [21] , [22] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ], nonopioid analgesia only [ 23 ], and non-divided intercostal muscle flap [ 24 ]. Only one study reported using a sham cryoanalgesia treatment in the comparator arm [ 19 ]. Fourteen studies did not report whether pain scores were at rest or with movement [ [22] , [23] , [24] , [25] , 27 , [29] , [30] , [31] , [33] , [34] , [35] , 37 , 39 , 40 ].…”

Ultrasound-Guided Percutaneous Cryoneurolysis for Postoperative Analgesia After Limb Amputation: A Case Series

“…9,10 Although 2 investigations demonstrated a statistically significant increase in neuropathic pain in patients who received cryoneurolysis administered via the surgical incision, 11,12 the majority of trials reported no increased risk of persistent postoperative pain. [13][14][15][16][17][18][19][20][21] Given the aforementioned studies, we felt the risk of long-term sequelae of cryoanalgesia was low, and the benefit of longterm control of acute pain was high in our 3 patients. It is also important to weigh the risks of long-term numbness in the affected nerve.…”

Peripheral Subcutaneous Electrostimulation for Control of Intractable Post-operative Inguinal Pain: A Case Report Series

“…branch of the genitofemoral, lateral femoral cutane-Ilioinguinal neuralgia characteristically causes a burning, dysesthetic sensation in the inguinal, super-varying degrees of success. This has included medi-CASE REPORT #1 cations, nerve injections, neuroablation, scar lysis, nerve transposition, and spinal cord stimula-RK is a 32-year-old male who presented to the University of Arizona Pain Management Center with a tion (1)(2)(3)(4)(5)(6)(7)(9)(10)(11). A subset of patients progress to intractable neuralgic symptoms despite these inter-three-year history of pain immediately following right inguinal herniorrhaphy.…”