Finneran John J, Ilfeld Brian M
Department of Anesthesiology, University of California San Diego, La Jolla, California, USA.
Department of Anesthesiology, University of California San Diego, La Jolla, California, USA
Reg Anesth Pain Med. 2025 Feb 5;50(2):168-174. doi: 10.1136/rapm-2024-105605.
Poorly controlled pain during the acute postoperative period is associated with the development of persistent or 'chronic' pain lasting months or years after surgery. Relatively small trials suggest that local anesthetic-based peripheral nerve blocks lasting hours or a few days may decrease persistent postsurgical pain for some surgical procedures, but definitive data is lacking. Two possible alternatives-percutaneous cryoneurolysis and peripheral nerve stimulation-are analgesic modalities with the potential to provide weeks or months of pain relief following surgery. This increase in analgesic duration raises the possibility of decreased transition from acute to chronic postsurgical pain.
This review aims to summarize the available evidence involving the use of percutaneous cryoneurolysis and peripheral nerve stimulation within the immediate perioperative period and its effects on decreasing chronic postoperative pain.
Two randomized trials (n=66 and 16) comparing active percutaneous peripheral nerve stimulation to sham stimulation and two randomized trials (n=60 and 7) comparing percutaneous cryoneurolysis to a sham procedure for postoperative pain are described in this review. In each trial, participants were followed for at least three months.
This review describes percutaneous cryoneurolysis and peripheral nerve stimulation for perioperative analgesia as well as the available evidence supporting their use to prevent persistent postsurgical pain.
急性术后疼痛控制不佳与术后数月或数年持续存在的“慢性”疼痛的发生有关。相对较小规模的试验表明，持续数小时或数天的基于局部麻醉的外周神经阻滞可能会减轻某些手术的术后持续性疼痛，但缺乏确凿的数据。两种可能的替代方法——经皮冷冻神经溶解术和外周神经刺激术——是有可能在术后提供数周或数月疼痛缓解的镇痛方式。这种镇痛持续时间的延长增加了减少从急性术后疼痛转变为慢性术后疼痛的可能性。
本综述旨在总结围手术期立即使用经皮冷冻神经溶解术和外周神经刺激术的现有证据及其对减少慢性术后疼痛的影响。
本综述描述了两项将主动经皮外周神经刺激与假刺激进行比较的随机试验（n = 66和16），以及两项将经皮冷冻神经溶解术与假手术用于术后疼痛进行比较的随机试验（n = 60和7）。在每项试验中，对参与者进行了至少三个月的随访。
本综述描述了用于围手术期镇痛的经皮冷冻神经溶解术和外周神经刺激术，以及支持其用于预防术后持续性疼痛的现有证据。
