1.Ultrasound-guided percutaneous intercostal cryoanalgesia for multiple weeks of analgesia following mastectomy: a case series
Rodney A. GABRIEL ; 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
Korean Journal of Anesthesiology 2020;73(2):163-168
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.
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