Interventional Management of Pain with Cryoneurolysis: Expert Consensus Recommendations for Standardizing Patient...

Area of Science:

• Pain Management
• Interventional Pain Medicine
• Neuromodulation

Background:

• Chronic pain affects millions globally, necessitating advanced treatment options.
• Cryoneurolysis offers a minimally invasive approach for localized pain management.
• Establishing standardized protocols is crucial for optimizing cryoneurolysis outcomes.

Purpose of the Study:

• To develop expert consensus recommendations for patient selection in cryoneurolysis.
• To define optimal procedural techniques for cryoneurolysis in chronic pain.
• To utilize a Delphi process for achieving expert agreement on cryoneurolysis.

Main Methods:

• A two-round Delphi process involving 22 international interventionists.
• Participants rated 42 statements on a 10-point Likert scale.
• Consensus defined as ≥75% of ratings ≥7.

Main Results:

• Strong agreement on cryoneurolysis for refractory localized pain and identifiable nerve targets.
• Imaging guidance deemed essential for accurate nerve identification and probe placement.
• Consensus reached on individualized freeze-thaw cycles and patient education; no consensus on treatment region limits or routine antibiotics.

Conclusions:

• Expert consensus establishes standards for cryoneurolysis patient selection and techniques.
• Mandatory imaging guidance and flexible freeze protocols are key recommendations.
• Areas for further research include treatment limitations and antibiotic use.