{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:06:55Z","timestamp":1790230015269,"version":"4.1.0"},"reference-count":47,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T00:00:00Z","timestamp":1580256000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Epimed International","award":["unrestricted research gift"],"award-info":[{"award-number":["unrestricted research gift"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,1,14]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cryoneurolysis of peripheral nerves uses localised intense cold to induce a prolonged block over multiple weeks that has the promise of providing potent analgesia outlasting the duration of postoperative pain following surgery, as well as treat other acute and chronic pain states. However, it remains unclear whether persistent functional motor deficits remain following cryoneurolysis of mixed sensorimotor peripheral nerves, greatly limiting clinical application of this modality. To help inform future research, we used a rat peroneal nerve injury model to evaluate if cryoneurolysis results in persistent deficits in motor function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Male Lewis rats (n=30) had their common peroneal nerves exposed bilaterally at the proximal lateral margin of the knee and subsequently underwent cryoneurolysis on one limb and sham treatment on the contralateral limb. Outcomes were evaluated on days 3, 14, 30, 90 and 180. The primary end point was motor function, based on ankle dorsiflexion torque. In addition, sensory function was tested based on von Frey\u2019s filament sensitivity to the peroneal sensory distribution. A subset of animals was sacrificed following functional testing at each time point, and general tissue morphology, connective tissue deposition, and axon counts were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Motor deficits in treated limbs were observed at 3 and 14 days but had resolved at time points beyond 1\u2009month. Bilateral sensory deficits were also observed at 3 and 14 days, and also resolved within 1\u2009month. Consistent with motor functional deficits, axon counts trended lower in treated nerves compared with contralateral controls at 3 days; however, axon counts were not significantly different at later time points.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>When applied to a mixed sensorimotor nerve, cryoneurolysis did not result in persistent motor deficits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2019-101141","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T05:05:21Z","timestamp":1580360721000},"page":"287-292","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Does cryoneurolysis result in persistent motor deficits? A controlled study using a rat peroneal nerve injury model"],"prefix":"10.1136","volume":"45","author":[{"given":"Sameer B","family":"Shah","sequence":"first","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Bremner","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Esparza","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanelle","family":"Dorn","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Orozco","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Haghshenas","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-3273","authenticated-orcid":false,"given":"Brian M","family":"Ilfeld","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4443-0021","authenticated-orcid":false,"given":"Rodney A","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Ward","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,29]]},"reference":[{"key":"2025101109522931000_45.4.287.1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1213\/ANE.0000000000001581","article-title":"Continuous peripheral nerve blocks: an update of the published evidence and comparison with novel, alternative analgesic modalities","volume":"124","author":"Ilfeld","year":"2017","journal-title":"Anesth Analg"},{"key":"2025101109522931000_45.4.287.2","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1002\/ana.410100512","article-title":"Biophysical and pathological effects of cryogenic nerve lesion","volume":"10","author":"Myers","year":"1981","journal-title":"Ann Neurol"},{"key":"2025101109522931000_45.4.287.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.33.5.625"},{"key":"2025101109522931000_45.4.287.4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.36076\/ppj.2003\/6\/345","article-title":"Cryoanalgesia in interventional pain management","volume":"6","author":"Trescot","year":"2003","journal-title":"Pain Physician"},{"key":"2025101109522931000_45.4.287.5","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-2388(199803)14:2<99::AID-SSU2>3.0.CO;2-1"},{"key":"2025101109522931000_45.4.287.6","first-page":"997","article-title":"Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain","volume":"12","author":"Campos","year":"2009","journal-title":"Pain Physician"},{"key":"2025101109522931000_45.4.287.7","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00256-017-2617-6","article-title":"MRI-guided cryoablation of the posterior femoral cutaneous nerve for the treatment of neuropathy-mediated sitting pain","volume":"46","author":"Joshi","year":"2017","journal-title":"Skeletal Radiol"},{"key":"2025101109522931000_45.4.287.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-014-2075-3"},{"key":"2025101109522931000_45.4.287.9","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1213\/XAA.0000000000000893","article-title":"Ultrasound-Guided percutaneous Cryoneurolysis for postoperative analgesia after limb amputation","volume":"12","author":"Gabriel","year":"2019","journal-title":"A & A Practice"},{"key":"2025101109522931000_45.4.287.10","doi-asserted-by":"crossref","first-page":"567","DOI":"10.4097\/kjae.2017.70.5.567","article-title":"Ultrasound-guided percutaneous cryoneurolysis providing postoperative analgesia lasting many weeks following a single administration: a replacement for continuous peripheral nerve blocks?: a case report","volume":"70","author":"Ilfeld","year":"2017","journal-title":"Korean J Anesthesiol"},{"key":"2025101109522931000_45.4.287.11","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.knee.2016.01.011","article-title":"Percutaneous freezing of sensory nerves prior to total knee arthroplasty","volume":"23","author":"Dasa","year":"2016","journal-title":"Knee"},{"key":"2025101109522931000_45.4.287.12","first-page":"180","article-title":"The effects of extreme cold on sensory nerves","volume":"62","author":"Barnard","year":"1980","journal-title":"Ann R Coll Surg Engl"},{"key":"2025101109522931000_45.4.287.13","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199509000-00022"},{"key":"2025101109522931000_45.4.287.14","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199509000-00021"},{"key":"2025101109522931000_45.4.287.15","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2482-3-3","article-title":"The use of a new miniature cryoprobe for ablation of bone tissue: in vivo assessment of the probe and application of the method to bone in a sheep model","volume":"3","author":"Popken","year":"2003","journal-title":"BMC Surg"},{"key":"2025101109522931000_45.4.287.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cryobiol.2010.09.006"},{"key":"2025101109522931000_45.4.287.17","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1213\/XAA.0000000000000546","article-title":"Ultrasound-guided percutaneous Cryoneurolysis for acute pain management: a case report","volume":"9","author":"Gabriel","year":"2017","journal-title":"A A Case Rep"},{"key":"2025101109522931000_45.4.287.18","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/00000542-199808000-00036","article-title":"Cryoanalgesia: a novel treatment for hip adductor spasticity and obturator neuralgia","volume":"89","author":"Kim","year":"1998","journal-title":"Anesthesiology"},{"key":"2025101109522931000_45.4.287.19","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000068822.10113.9E"},{"key":"2025101109522931000_45.4.287.20","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg"},{"key":"2025101109522931000_45.4.287.21","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/bja\/aex142","article-title":"Ultrasound-guided percutaneous cryoneurolysis for treatment of acute pain: could cryoanalgesia replace continuous peripheral nerve blocks?","volume":"119","author":"Ilfeld","year":"2017","journal-title":"Br J Anaesth"},{"key":"2025101109522931000_45.4.287.22","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2003.048462"},{"key":"2025101109522931000_45.4.287.23","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/mus.25707","article-title":"Recovery of rat muscle size but not function more than 1 year after a single botulinum toxin injection","volume":"57","author":"Ward","year":"2018","journal-title":"Muscle Nerve"},{"key":"2025101109522931000_45.4.287.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2010.07.009"},{"key":"2025101109522931000_45.4.287.25","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0270(94)90144-9"},{"key":"2025101109522931000_45.4.287.26","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.4103\/1673-5374.251338","article-title":"Redistribution of nerve strain enables end-to-end repair under tension without inhibiting nerve regeneration","volume":"14","author":"Howarth","year":"2019","journal-title":"Neural Regen Res"},{"key":"2025101109522931000_45.4.287.27","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/0011-2240(74)90093-5","article-title":"Ice crystals formed in tissues during cryosurgery. I. Light microscopy","volume":"11","author":"Whittaker","year":"1974","journal-title":"Cryobiology"},{"key":"2025101109522931000_45.4.287.28","doi-asserted-by":"publisher","DOI":"10.1016\/0011-2240(74)90094-7"},{"key":"2025101109522931000_45.4.287.29","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1006\/exnr.1995.1028","article-title":"Peripheral nerve pathology following sciatic Cryoneurolysis: relationship to neuropathic behaviors in the rat","volume":"133","author":"Wagner","year":"1995","journal-title":"Exp Neurol"},{"key":"2025101109522931000_45.4.287.30","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(93)91339-T"},{"key":"2025101109522931000_45.4.287.31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/0031-9384(95)00037-J","article-title":"Gender differences in autotomy following sciatic cryoneurolysis in the rat","volume":"58","author":"Wagner","year":"1995","journal-title":"Physiol Behav"},{"key":"2025101109522931000_45.4.287.32","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4522(95)00495-5"},{"key":"2025101109522931000_45.4.287.33","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)90145-7"},{"key":"2025101109522931000_45.4.287.34","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)90194-5"},{"key":"2025101109522931000_45.4.287.35","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/mus.24306","article-title":"Wallerian degeneration and recovery of motor nerves after multiple focused cold therapies","volume":"51","author":"Hsu","year":"2015","journal-title":"Muscle Nerve"},{"key":"2025101109522931000_45.4.287.36","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00702-013-1077-y","article-title":"Reduction in muscular motility by selective focused cold therapy: a preclinical study","volume":"121","author":"Hsu","year":"2014","journal-title":"J Neural Transm"},{"key":"2025101109522931000_45.4.287.37","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.12213","article-title":"Stretch speed-dependent myofiber damage and functional deficits in rat skeletal muscle induced by lengthening contraction","volume":"2","author":"Mori","year":"2014","journal-title":"Physiol Rep"},{"key":"2025101109522931000_45.4.287.38","doi-asserted-by":"publisher","DOI":"10.1089\/08977150260190465"},{"key":"2025101109522931000_45.4.287.39","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-00115550-200805000-00004"},{"key":"2025101109522931000_45.4.287.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2004.07.096"},{"key":"2025101109522931000_45.4.287.41","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.23-03-01026.2003"},{"key":"2025101109522931000_45.4.287.42","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-2236(98)01302-2"},{"key":"2025101109522931000_45.4.287.43","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(00)01142-3"},{"key":"2025101109522931000_45.4.287.44","first-page":"211","article-title":"Neurovascular compression syndromes","volume":"9","author":"Rob","year":"1975","journal-title":"Adv Surg"},{"key":"2025101109522931000_45.4.287.45","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(02)00169-4"},{"key":"2025101109522931000_45.4.287.46","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/j.1439-0264.1997.tb00115.x","article-title":"Morphometric comparison between contralateral sciatic nerves in the male and female rabbit","volume":"26","author":"Muglia","year":"1997","journal-title":"Anat Histol Embryol"},{"key":"2025101109522931000_45.4.287.47","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1002\/ar.23161","article-title":"Differences exist in the left and right sciatic nerves of na\u00efve rats and cats","volume":"298","author":"Christensen","year":"2015","journal-title":"Anat Rec"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2019-101141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T16:52:42Z","timestamp":1760201562000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2019-101141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,29]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,3,19]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/rapm-2019-101141"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2019-101141","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,29]]}}}