Sen Sudipta, De Haan Johanna B, Mehrafza Mariam, Hernandez Nadia
Anesthesiology and Perioperative Medicine, McGovern Medical School University of Texas Health Science Center, Houston, USA.
Anesthesiology, McGovern Medical School University of Texas Health Science Center, Houston, USA.
Cureus. 2023 Jan 22;15(1):e34066. doi: 10.7759/cureus.34066. eCollection 2023 Jan.
Cryoneurolysis is an analgesic method that has been shown to provide extended pain relief in postoperative patients. However, to date, this method has not been described in nonsurgical inpatients with chronic pain experiencing an acute exacerbation. This analgesic modality has the potential to provide pain relief for patients whose expected duration of severe acute pain would outlast that of other regional anesthetic techniques while avoiding opioid escalation and facilitating discharge. We present a patient with acute exacerbation of chronic pain from breast ulcerations caused by congenital lipomatous overgrowth, vascular malformations, epidermal nevis, spinal/skeletal anomalies/scoliosis (CLOVES) syndrome that was successfully treated as an inpatient with a portable cryoneurolysis device. This is the first reported use of cryoneurolysis in an inpatient setting to treat acute-on-chronic pain in a nonsurgical patient. The authors recommend regional anesthesiologists and acute pain specialists to utilize this technique to provide analgesia in patients with complex pain to facilitate hospital throughput.
冷冻神经lysis是一种镇痛方法，已被证明能为术后患者提供持久的疼痛缓解。然而，迄今为止，这种方法尚未在患有慢性疼痛急性加重的非手术住院患者中得到描述。这种镇痛方式有可能为那些预期严重急性疼痛持续时间超过其他区域麻醉技术的患者提供疼痛缓解，同时避免阿片类药物用量增加并促进出院。我们报告了一名因先天性脂肪瘤过度生长、血管畸形、表皮痣、脊柱/骨骼异常/脊柱侧凸（CLOVES）综合征导致乳腺溃疡引起慢性疼痛急性加重的患者，该患者作为住院患者使用便携式冷冻神经lysis设备成功得到治疗。这是首次报道在住院环境中使用冷冻神经lysis治疗非手术患者的慢性疼痛急性发作。作者建议区域麻醉医生和急性疼痛专家利用这种技术为复杂疼痛患者提供镇痛，以促进医院的工作效率。
