Cryoablation means deliberately freezing living cells of a localized area of interest at extreme cold. Cryoablation is well-known for tumor ablation in treatment of cancer. However, ablation of pain carrying nerve for management of intractable pain was not popular as cryoprobes of smaller diameter were not available. But with the improvement of science and technology, a very small-sized lesion is possible with modern cryo-probes of very small diameter similar to a small needle. These are very safe, and the technique of ablation of pain carrying nerves for management of intractable pain is called cryoneurolysis.
Daradia: The Pain Clinic and the hospital is a reputed institute of Kolkata that is famous in India and abroad for treating different types of pain. This institute also conducts different training programs of post-graduate doctors from different specialties like anaesthesia, orthopaedics, neurology, etc. in pain management. It is was the first hospital in India to start cryoneurolysis for pain management with modern cryoprobes. Doctors from all over India and abroad use to come to this hospital to learn cryoneurolysis for pain management.
The cryoneurolysis is a non-surgical interventional pain management technique that is used when medicines have failed to give adequate pain relief and where surgery cannot be done for some reasons including the unwillingness of patients for surgical interventions. This is done for the management of cancer pain, back pain, neck pain, headaches, shoulder pain, knee pain, nerve pain, etc. because of Trigeminal neuralgia, sacroiliac joint arthritis, hip arthritis, frozen shoulder, cervicogenic headache, osteoarthritis of knee and many other types of acute and chronic pain. The procedure is done as a day-care procedure, and the patient is discharged on the same day. As a result, patients enjoy immediate pain relief, which lasts for a long time.
The procedure is done under the guidance of ultrasonography, where important deeper structures, including the target nerve, are visualized before doing the procedure. In addition, the ice-ball at the tip of the cryoprobe is also visualized, and damage to other structures can be easily avoided.
The advantages of cryoneurolysis are many. First, it is a non-surgical and day-care procedure. Second, this procedure is less costly than surgical procedures. Third, the side effects or complications are rare and several times less than surgery.
The Director of this hospital Dr. Gautam Das explained that nitrous oxide or carbon di-oxide gas is passed under very high pressure through probes. The gas is expanded at the probe’s tip and returns through a larger inner channel inside the cryoprobe. Thus, the tip is cooled. Its mechanism is similar to a refrigerator or an air-conditioner machine. These probes are like tiny needles with sharp blind tips. These probes are placed very close to the pain-carrying nerves identified with an ultrasound scan and ablated safely for permanent pain relief.
Cryoneurolysis is a most modern pain management technique and is becoming popular in USA and European countries. In India it is rarely done. Daradia: The Pain Clinic and hospital is the only hospital in India where cryoneurolysis is regularly practiced for pain management.
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