Trial reportAnesthesiology2023
Ultrasound-guided Percutaneous Cryoneurolysis to Treat Chronic Postamputation Phantom Limb Pain: A Multicenter Randomized Controlled Trial.
Trial report in Anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Beyond traditional therapies: a network meta-analysis on the treatment efficacy for chronic phantom limb pain.Regional anesthesia and pain medicine · 2025Pooled it
- Cryoneurolysis for phantom limb pain: a systematic review.Pain management · 2024Pooled it
- Cryoanalgesia to treat phantom limb pain following a trans-femoral (above-knee) amputation: a randomized, sham-controlled pilot study.Regional anesthesia and pain medicine · 2026Trial
- Cryoneurolysis Thermal Graphs: In Vivo Descriptive Data from Ultrasound-guided Percutaneous Thermocouples.Anesthesiology · 2026Article
- Treatment of residual and phantom limb pain using percutaneous ablation: a systematic review and meta-analysis.Frontiers in rehabilitation sciences · 2026Review
- Ultrasound-Guided Interventions for Neuropathic Pain: A Narrative Pictorial Review.Life (Basel, Switzerland) · 2025Review
- Targeted Interventional Therapies for the Management of Postamputation Pain: A Comprehensive Review.Biomedicines · 2025Review
- Innovations in Chronic Pain Treatment: A Narrative Review on the Role of Cryoneurolysis.Medicina (Kaunas, Lithuania) · 2025Review
- Cryoneurolysis for Post Operative Pain Following Chest Surgery: Contemporary Evidence and Future Directions.Current pain and headache reports · 2025Review
- A Review of Nonsurgical Neurolytic Procedures for Neuropathic Pain.Journal of pain research · 2025Review
- Radiofrequency and Cryoneurolysis in Pain Management: Development, Technique, and Application.Pain research & management · 2025Review
- A Narrative Review of Ultrasound-Guided and Landmark-based Percutaneous Cryoneurolysis for the Management of Acute and Chronic Pain.Current pain and headache reports · 2024Review
- Multidisciplinary strategies to treat painful mononeuropathies in the upper extremity: from lab to bedside.The Journal of hand surgery, European volume · 2024Review
- Applications of Cryoneurolysis in Chronic Pain Management: a Review of the Current Literature.Current pain and headache reports · 2024Review
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 2 institutions in 4 countries.
Funding
Abstract
backgroundPostamputation phantom pain is notoriously persistent with few validated treatments. Cryoneurolysis involves the application of low temperatures to reversibly ablate peripheral nerves. The authors tested the hypothesis that a single cryoneurolysis treatment would decrease phantom pain 4 months later.
methodsThe authors enrolled patients with a lower-limb amputation and established phantom pain. Each received a single-injection femoral and sciatic nerve block with lidocaine and was subsequently randomized to receive either ultrasound-guided percutaneous cryoneurolysis or sham treatment at these same locations. The primary outcome was the change in average phantom pain intensity between baseline and 4 months as measured with a numeric rating scale (0 to 10), after which an optional crossover treatment was offered. Investigators, participants, and clinical staff were masked to treatment group assignment with the exception of the treating physician performing the cryoneurolysis, who had no subsequent participant interaction.
resultsPretreatment phantom pain scores were similar in both groups, with a median [quartiles] of 5.0 [4.0, 6.0] for active treatment and 5.0 [4.0, 7.0] for sham. After 4 months, pain intensity decreased by 0.5 [-0.5, 3.0] in patients given cryoneurolysis (n = 71) versus 0 [0, 3] in patients given sham (n = 73), with an estimated difference (95% CI) of -0.1 (-1.0 to 0.7), P = 0.759. Following their statistical gatekeeping protocol, the authors did not make inferences or draw conclusions on secondary endpoints. One serious adverse event occurred after a protocol deviation in which a femoral nerve cryolesion was induced just below the inguinal ligament-instead of the sensory-only saphenous nerve-which resulted in quadriceps weakness, and possibly a fall and clavicle fracture.
conclusionsPercutaneous cryoneurolysis did not decrease chronic lower extremity phantom limb pain 4 months after treatment. However, these results were based upon the authors' specific study protocol, and since the optimal cryoneurolysis treatment parameters such as freeze duration and anatomic treatment location remain unknown, further research is warranted. EDITOR’S PERSPECTIVE:
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.