Kalava Arun, Kassie Ronaldo, Borick Ellie
Anesthesiology, University of Central Florida College of Medicine, Orlando, USA.
Pain Management, TampaPainMD, Tampa, USA.
Cureus. 2024 Sep 30;16(9):e70557. doi: 10.7759/cureus.70557. eCollection 2024 Sep.
Cryoneurolysis is a procedure that has been shown to be efficacious in managing pain in various settings. Multiple studies have demonstrated the benefit of cryoneurolysis; however, the literature on managing postherpetic neuralgia with cryoneurolysis is scarce. The current treatment options available include transdermal lidocaine patches, capsaicin, non-steroidal anti-inflammatory drugs, nerve blocks, antidepressants, anticonvulsants, and opioids. Pain-relieving treatments such as opioids can have long-term detrimental effects on a patient or be ineffective for long-term pain relief, so there is cause to explore alternative treatment options. Here, we present a case of ultrasound-guided cryoneurolysis of the intercostal nerves for the management of postherpetic neuralgia after herpes zoster bilateralis symmetricus. After several treatment options were unsuccessful in alleviating this patient's pain, cryoneurolysis of the intercostal nerves proved to be a very effective pain management tool.
冷冻神经lysis是一种已被证明在各种情况下管理疼痛有效的方法。多项研究证明了冷冻神经lysis的益处；然而，关于用冷冻神经lysis治疗带状疱疹后神经痛的文献却很稀少。目前可用的治疗选择包括透皮利多卡因贴剂、辣椒素、非甾体抗炎药、神经阻滞、抗抑郁药、抗惊厥药和阿片类药物。诸如阿片类药物等止痛治疗可能会对患者产生长期有害影响，或者对长期缓解疼痛无效，因此有理由探索替代治疗选择。在此，我们报告一例超声引导下肋间神经冷冻神经lysis治疗双侧对称性带状疱疹后神经痛的病例。在几种治疗选择未能缓解该患者的疼痛后，肋间神经冷冻神经lysis被证明是一种非常有效的疼痛管理工具。
