Episode 3: Percutaneous Cryoneurolysis of the LFCN for Analgesia Following Skin Grafting.

This month’s “RAPM Focus” highlights a small study conducted by a team out of the University of California San Diego, designed to determine if percutaneous cryoneurolysis of the lateral femoral cutaneous nerve is feasible and shows potential for future study in management of burn patients. Dr. John J. Finneran is the first author of “Percutaneous cryoneurolysis of the lateral femoral cutaneous nerve for analgesia following skin grafting: a randomized, controlled pilot study,” published first in August 2021 and subsequently in the January 2022 print edition (https://rapm.bmj.com/content/47/1/60). As Dr. Finneran reported in the paper, peripheral nerve blocks may be used for postoperative analgesia following split thickness skin graft, and the lateral femoral cutaneous nerve is “an optimal target, since it innervates the lateral thigh and has no motor component.” However, because local anesthetic nerve blocks are limited in their duration, this study looked at the use of ultrasound-guided percutaneous cyroneurolysis for extended analgesic effect. The results were promising, with the patients who were randomized to the cryoneurolysis group having lower average and maximum pain scores, less need for opioid analgesics, and fewer reports of sleep disturbances during the first two nights after surgery. Listen in as Dr. Finneran describes the study, the procedure, and future research objectives. Dr. Finneran is a Health Sciences clinical associate professor and associate residency program director in the Department of Anesthesiology at the University of California San Diego, as well as clinical director for Regional Anesthesiology at UC San Diego Medical Center – Hillcrest. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

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