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Ultrasound-Guided Percutaneous Cryoneurolysis for Postoperative Analgesia After Limb Amputation

A Case Series

Gabriel, Rodney A., MD, MAS*; Finneran, John J. IV, MD*; Trescot, Andrea M., MD; Ilfeld, Brian M., MD, MS*

doi: 10.1213/XAA.0000000000000893
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Pain after limb amputation is frequently challenging to adequately treat with local anesthetic-based regional anesthesia techniques due to its relatively long duration. Furthermore, uncontrolled pain in the immediate postoperative period is associated with persistent postsurgical pain, and frequently phantom limb pain. Cryoneurolysis is an alternative regional analgesic method to local anesthesia-based techniques. We report 3 cases in which ultrasound-guided percutaneous cryoneurolysis was performed in the perioperative period of limb amputation. All reported profound analgesia in the postoperative period without persistent postsurgical residual limb or phantom pain in the following months. No adverse events associated with the cryoneurolysis procedure occurred.

From the *University of California, San Diego, San Diego, California

Pain and Headache Center, Eagle River, Alaska.

Accepted for publication August 14, 2018.

Funding: Myoscience (Fremont, California) provided the cryoneurolysis device and probes used for these cases.

Conflicts of Interest: See Disclosures at the end of the article.

Address correspondence to Rodney A. Gabriel, MD, MAS, University of California, San Diego, 200 West Arbor Dr, MC 8770, San Diego, CA 92103. Address e-mail to ragabriel@ucsd.edu.

© 2019 International Anesthesia Research Society
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