Ultrasound-guided percutaneous cryoneurolysis for treatment of acute pain: could cryoanalgesia replace continuous peripheral nerve blocks?

Local anaesthetics, delivered percutaneously through a needle, have been used for over a century to provide perioperative anaesthesia and analgesia. However, the duration of a single-injection peripheral nerve block is usually limited to less than 24 hr, leaving untreated surgical pain that may last for weeks—or in some cases months. While prolonged analgesia may be provided using a perineural catheter and repeated/continuous administration of local anaesthetic, the duration of this modality is still usually limited to less than one week because of the risk of infection, rapid consumption of the local anaesthetic, and the burden of carrying an infusion pump and anaesthetic reservoir.1 An analgesic modality with a prolonged duration of action could be advantageous for various surgical procedures that are associated with a typically prolonged postoperative period of pain.

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