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Abstract

1. 2020;4;217-220 A Novel Introducer for Ultrasound-Guided Cryoneurolysis Administration to Improve Patient Safety and Functionality
   Case Report
   John J. Finneran, IV, MD, Brenton Alexander, MD, Brian M. Ilfeld, MD, and Andrea M. Trescot, MD.

BACKGROUND: Percutaneous cryoneurolysis provides prolonged postoperative analgesia by placing a probe adjacent to a peripheral nerve and cooling the probe tip, inducing a reversible block that lasts weeks to months. Unfortunately, freezing the nerve can produce significant pain. Consequently, local anesthetic is generally applied to the nerve prior to cryoneurolysis, which, until now, required an additional needle insertion increasing both the risks and duration of the procedure.

CASE PRESENTATION: Three patients underwent ultrasound-guided percutaneous cryoneurolysis of either the sciatic and saphenous nerves or the femoral nerve. In all patients, the local anesthetic injection and cryoneurolysis were accomplished with a single needle pass using the novel probe introducer.

CONCLUSION: This introducer allows perineural local anesthetic injection followed immediately by cryoneurolysis, thereby sparing patients a second skin puncture, lowering the risks of the procedure, and decreasing the overall time required for cryoneurolysis.

KEY WORDS: Cryoablation, cryoanalgesia, peripheral nerve block, postoperative analgesia, ultrasound

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