Regional Anesthesia with Cryoneurolysis: an Ancient Technique with New Possibilities for Acute Pain

Purpose of Review This review summarizes the history, mechanism, and current understanding of cryoneurolysis. It discusses the implications for utilizing percutaneous cryoneurolysis for both elective perioperative and traumatic acute pain. Recent Findings The goal of cryoneurolysis is Wallerian degeneration with preservation of endoneurium to provide a lattice for axonal regeneration without neuroma formation. Ultrasound guidance has expanded the use of percutaneous cryoneurolysis as an analgesic option in the perioperative period. The quantity of data supporting percutaneous cryoneurolysis in the setting of acute postoperative pain management continues to grow for both patients undergoing planned elective surgical procedures and patients with traumatic injuries. Summary Ultrasound-guided percutaneous cryoneurolysis can prolong postoperative analgesia. Studies focusing on efficacy and complications for both perioperative and traumatic acute pain remain limited, and more randomized controlled trials are needed to further elucidate long-term benefits and risks.