Ultrasound-guided percutaneous intercostal cryoanalgesia for multiple weeks of analgesia following mastectomy: a case series
- Author:
Rodney A. GABRIEL
1
;
John J. FINNERAN
;
Matthew W. SWISHER
;
Engy T. SAID
;
Jacklynn F. SZTAIN
;
Bahareh KHATIBI
;
Anne M. WALLACE
;
Ava HOSSEINI
;
Andrea M. TRESCOT
;
Brian M. ILFELD
Author Information
- Publication Type:Case Report
- From:Korean Journal of Anesthesiology 2020;73(2):163-168
- CountryRepublic of Korea
-
Abstract:
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.
