Cryoneurolysis for management of post-mastectomy pain: a systematic review.

Aims: Post-mastectomy pain syndrome is a common postoperative complication that can impact patient quality of life and function. The aim of this systematic review is to evaluate the effectiveness of cryoneurolysis as an intervention for the management of post-mastectomy pain.
Methods: A prospero-registered systematic review was performed following PRISMA 2020 guidelines. An initial screening consisted of 53 articles imported from the following databases: PubMed, Embase, Web of Science, Cochrane, and Scopus. Google Scholar and WorldCat were also searched to pull any further articles.
Results: Three clinical trials, one case series, and one case report were included. Primary outcome measure of patient reported pain score (VAS or NRS) showed clinically significant reduction in pain in all five studies. Three of the studies also reported reduction in opioid use with cryoneurolysis intervention. A pooled effect size of Hedges g = -0.963, (95% CI [-1.55, -0.373]), with heterogeneity (I ²  = 0.70).
Conclusion: Cryoneurolysis intervention shows promising and clinically significant relief in post-mastectomy pain in patients and further studies are encouraged.