Cryoanalgesia for pain management after open thoracotomy: a reply

We thank Ju and Feng for their comment regarding the use of cryoanalgesia for pain management after open thoracic surgery 1. We agree that one of the potential risks of cryoanalgesia is the occurrence of chronic pain. We would like to emphasise that the PROSPECT recommendations clearly state that cryoanalgesia is appropriate only when epidural analgesia is not possible 2. Cryoanalgesia is not used routinely in clinical practice and is recommended instead as an alternate analgesic intervention. Devices used for cryoanalgesia have improved significantly in recent years. A hand-held device that uses nitrous oxide has been evaluated for pain relief in patients undergoing mastectomy 3. We now require further studies to confirm the risk/benefit balance of cryoanalgesia in patients undergoing open thoracic surgery.