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Utilising intraoperative hand-held cryoneurolysis for enhanced post-thoracotomy pain control
Sydney C Eierle1, Ashley B Anderson2,3, Philip S Mullinex4
1Department of Surgery, Uniformed Services University, Bethesda, Maryland, USA.
BMJ Case Reports
|April 28, 2025
Summary
Intraoperative cryoneurolysis (IC) may reduce post-thoracotomy pain (PTP) and opioid use after thoracic surgery. This case series suggests IC offers a promising approach for managing PTP effectively.
Area of Science:
- Pain Management
- Thoracic Surgery
- Interventional Pain Medicine
Background:
- Post-thoracotomy pain (PTP) is a common and often debilitating complication following thoracic surgery.
- Limited understanding exists regarding the efficacy of intraoperative interventions for PTP management.
Purpose of the Study:
- To evaluate the potential of intraoperative cryoneurolysis (IC) in managing PTP.
- To assess the impact of IC on pain reduction and opioid consumption in patients undergoing thoracic surgery.
Main Methods:
- Retrospective case series involving three patients undergoing thoracic surgery for chest wall tumors.
- Direct visualization and temporary inhibition of intercostal nerve signaling using a handheld cryoneurolysis device.
- Assessment of pain levels and opioid reliance during the 6-week postoperative period.
Main Results:
- All three patients reported decreased pain post-surgery.
- Reduced reliance on opioid analgesics was observed in all patients during the 6-week follow-up.
- Intraoperative cryoneurolysis was performed without disrupting surrounding tissues.
Conclusions:
- Intraoperative cryoneurolysis shows potential as an effective method for managing post-thoracotomy pain.
- IC may offer a valuable strategy to decrease postoperative pain and opioid requirements in thoracic surgery patients.
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