Cryoanalgesia

Excerpt

The use of cold temperatures for analgesia has been in medical practice for thousands of years, with the first written account by Hippocrates where he described snow being carried down from high places and applied to wounds for pain control. In the 1800’s Napoleon’s surgeon general remarked on the ease and relative painless amputation of the limbs of soldiers who were exposed to the elements in Russia. Also in the 1800s, the discovery of ether and ethyl chloride spray for topical anesthesia was introduced. The modern iteration of cryoanalgesia was developed by Cooper et al. in 1962 when liquid nitrogen was introduced via a long probe targeted to specific nerves with an average temperature of -196 °C. In 1976, the first large paper showing benefit was published. Lloyd et al. demonstrated a significant reduction in pain for 52 of 64 patients with intractable pain treated with cryoanalgesia (including sciatic, intercostal, and facial nerves). The median duration of pain relief was 11 days, with some patients having significant pain relief for up to 224 days. Since this time, many delivery devices, and targets have been investigated.