Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain
Background: Establishing adequate analgesia for rib and sternal fractures remains a challenge due to the prolonged nature of the associated pain. Historically, cryoneurolysis has demonstrated beneficial in treating chronic pain, and the recent development of hand-held devices has allowed its functio...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Trauma Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644022001479 |
| _version_ | 1811168412572844032 |
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| author | A.P. Kwater S. Sen J.B. de Haan M.A. Ge A.M. Kim N. Hernandez |
| author_facet | A.P. Kwater S. Sen J.B. de Haan M.A. Ge A.M. Kim N. Hernandez |
| author_sort | A.P. Kwater |
| collection | DOAJ |
| description | Background: Establishing adequate analgesia for rib and sternal fractures remains a challenge due to the prolonged nature of the associated pain. Historically, cryoneurolysis has demonstrated beneficial in treating chronic pain, and the recent development of hand-held devices has allowed its functionality to expand into the management of acute pain. Case: We present a polytrauma patient with sternal and multiple rib fractures that underwent ultrasound-guided intercostal cryoneurolysis at bedside, resulting in significant analgesia lasting several weeks and improving mobilization. This is the first report of the utilization of cryoneurolysis to treat acute sternal fracture pain. Conclusion: The most common sternal fracture pattern is transverse which only requires treatment of four intercostal nerves, making cryoneurolysis feasible in trauma centers. This portable, minimally invasive, and low risk technique has the added benefits of reducing opioid requirements, decreasing length of hospital stay, and improving mobility in polytrauma patients. |
| first_indexed | 2024-04-10T16:26:58Z |
| format | Article |
| id | doaj.art-7fce53d123644a49abbf8b346dcba29c |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-04-10T16:26:58Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-7fce53d123644a49abbf8b346dcba29c2023-02-09T04:14:14ZengElsevierTrauma Case Reports2352-64402023-02-0143100751Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture painA.P. Kwater0S. Sen1J.B. de Haan2M.A. Ge3A.M. Kim4N. Hernandez5University of Texas MD Anderson Cancer Center, Department of Anesthesiology & Perioperative Medicine, 1400 Holcombe Blvd., Unit 409, Houston, TX 77030, United States of AmericaMcGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of AmericaMcGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of AmericaMcGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of AmericaMcGovern School of Medicine at UTHealth, 6431 Fannin Street, Houston, TX 77030, United States of America; Corresponding author.McGovern School of Medicine at UTHealth, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of AmericaBackground: Establishing adequate analgesia for rib and sternal fractures remains a challenge due to the prolonged nature of the associated pain. Historically, cryoneurolysis has demonstrated beneficial in treating chronic pain, and the recent development of hand-held devices has allowed its functionality to expand into the management of acute pain. Case: We present a polytrauma patient with sternal and multiple rib fractures that underwent ultrasound-guided intercostal cryoneurolysis at bedside, resulting in significant analgesia lasting several weeks and improving mobilization. This is the first report of the utilization of cryoneurolysis to treat acute sternal fracture pain. Conclusion: The most common sternal fracture pattern is transverse which only requires treatment of four intercostal nerves, making cryoneurolysis feasible in trauma centers. This portable, minimally invasive, and low risk technique has the added benefits of reducing opioid requirements, decreasing length of hospital stay, and improving mobility in polytrauma patients.http://www.sciencedirect.com/science/article/pii/S2352644022001479CryoneurolysisAcute painSternal fractureIntercostal nervePersistent painTrauma |
| spellingShingle | A.P. Kwater S. Sen J.B. de Haan M.A. Ge A.M. Kim N. Hernandez Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain Trauma Case Reports Cryoneurolysis Acute pain Sternal fracture Intercostal nerve Persistent pain Trauma |
| title | Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| title_full | Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| title_fullStr | Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| title_full_unstemmed | Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| title_short | Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| title_sort | ultrasound guided percutaneous cryoneurolysis for management of acute sternal fracture pain |
| topic | Cryoneurolysis Acute pain Sternal fracture Intercostal nerve Persistent pain Trauma |
| url | http://www.sciencedirect.com/science/article/pii/S2352644022001479 |
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