Ultrasound-guided percutaneous intercostal cryoanalgesia for multiple weeks of analgesia following mastectomy: a case series

Korean Journal of Anesthesiology

John J. Finneran¹  Matthew W. Swisher¹  Brian M. Ilfeld¹  Rodney A. Gabriel¹  Engy T. Said¹  Jacklynn F. Sztain¹  Bahareh Khatibi¹  Anne M. Wallace²  Ava Hosseini²  Andrea M. Trescot³ 

[1] Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA;Department of Surgery, University of California, San Diego, La Jolla, CA, USA;Pain and Headache Center, Eagle River, AK, USA;

关键词: acute pain;    cryoanalgesia;    cryoneurolysis;    mastectomy;    regional anesthesia;   

DOI  :  10.4097/kja.19332

来源: DOAJ

【 摘 要 】

Background Acute post-mastectomy pain is frequently challenging to adequately treat with local anesthetic-based regional anesthesia techniques due to its relatively long duration measured in multiple weeks. Case We report three cases in which preoperative ultrasound-guided percutaneous intercostal nerve cryoneurolysis was performed to treat pain following mastectomy. Across all postoperative days and all three patients, the mean pain score on the numeric rating scale was 0 for each day. Similarly, no patient required any supplemental opioid analgesics during the entire postoperative period; and, no patient reported insomnia or awakenings due to pain at any time point. This was a significant improvement over historic cohorts. Conclusions Ultrasound-guided percutaneous cryoanalgesia is a potential novel analgesic modality for acute pain management which has a duration that better-matches mastectomy than other currently-described techniques. Appropriately powered randomized, controlled clinical trials are required to demonstrate and quantify both potential benefits and risks.

【 授权许可】

Unknown