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Neural Selective Cryoneurolysis with Ice Slurry Injection in a Rat Model
Lilit Garibyan1, Sara Moradi Tuchayi, Ying Wang
1From the Wellman Center for Photomedicine, Massachusetts General Hospital and Department of Dermatology, Harvard Medical School, Boston, Massachusetts (L.G., S.M.T., Y.W., A.K., M.P., S.O., C.L.E., R.R.A.) Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (A.S.-R.) Massachusetts General Hospital and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts (J.M.) Brigham and Women's Hospital and Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Boston, Massachusetts (G.S.).
Injectable ice slurry offers a novel, drug-free approach to cryoneurolysis for pain management. This method selectively targets nerves, reducing pain for extended periods with full recovery, avoiding opioid risks.
Area of Science:
- Biomedical Engineering
- Pain Management
- Regenerative Medicine
Background:
- Postoperative pain is a significant clinical challenge, often managed with opioids, contributing to addiction and the opioid epidemic.
- Current cryoneurolysis methods are invasive, technically difficult, and lack tissue selectivity.
- There is a need for safer, more effective, and targeted pain relief strategies.
Purpose of the Study:
- To investigate the efficacy of injectable ice slurry as a novel, drug-free method for cryoneurolysis and analgesia.
- To determine the tissue selectivity and safety of ice slurry injections for nerve treatment.
- To evaluate the impact of ice slurry on nerve structure and function.
Main Methods:
- Developed an injectable, biocompatible ice slurry for cryoneurolysis.
- Utilized rat sciatic nerve model to assess ice slurry effects on nerve structure and function.
- Employed advanced microscopy (Coherent anti-Stokes Raman Scattering, light, fluorescent) and functional nerve testing.
Main Results:
- Ice slurry injection selectively targeted the rat sciatic nerve, demonstrating injectability and infiltration capabilities.
- A single injection was safe and selective, reversibly disrupting myelin sheaths and axon density.
- Significant reduction in mechanical pain response (up to 68%) observed for up to 60 days, with complete structural and functional recovery by day 112.
Conclusions:
- Injectable ice slurry provides a safe, selective, and effective method for cryoneurolysis.
- This approach offers a promising non-opioid alternative for long-lasting postoperative pain management.
- The technique shows potential for targeted nerve treatment with minimal surrounding tissue damage.
