[Short-Term Cryotherapy--Putting Dynamic Foot and Ankle Stability at Risk?]. / Beeinflusst die Kühlsprayanwendung am Fuß die dynamische Stabilisationsfähigkeit?

BACKGROUND: The application of ice or other forms of cooling represent a common method to treat acute musculoskeletal injuries during sporting events in order to reduce pain. Often athletes return to competition immediately after cooling. It is not known if short-term cryotherapy in the form of ice spray has an influence on the joint's dynamic stability. The aim of this study was to investigate if application of ice spray to the ankle has an effect on the dynamic stability of the joint in healthy participants. METHODS: A randomized controlled single-blind pilot study with crossover-design was conducted. 22 healthy athletic participants (15 women, 7 men, mean age 31.8 years ± 5.7) were included. Time-to-stability (TTS) was used to investigate the effect of the interventions, ice spray and water spray, applied on the lateral ankle. TTS was assessed in medio-lateral (ML) and antero-posterior (AP) direction on a force plate with two different tests (side step down and 1-leg jump). Collected co-variables were age, gender, height, weight, previous ankle injuries, Tegner activity scale and leg dominance. RESULTS: There were no significant differences between the two tests (side step down and 1-leg jump) in TTS after the application of ice spray or a water spray compared to the baseline (p > 0.05). There was no significant difference between the two interventions. The testing of the co-variable "previous ankle injury" showed a significant influence on the TTS in medio-lateral direction in the 1-leg jump test of the non-dominant leg after application of ice spray (p = 0.027). On the dominant leg same tendency could be found (p = 0.062). CONCLUSION: The application of ice spray to the lateral ankle does not have an effect on dynamic stability in healthy participants. In participants with a previous ankle injury a significant decrease in dynamic stability after application of ice spray could be shown. Whether further factors affecting stability such as fatigue and the influence of an opponent player or the application of ice spray on adjacent muscles may augment this effect should be subject to future investigations.

Comparison of the analgesic effects of cryoanalgesia vs. parecoxib for lung cancer patients after lobectomy.

This study was designed to compare the analgesic effects of cryoanalgesia and parecoxib in lung cancer patients after lobectomy. A total of 178 lung cancer patients awaiting large-sized lobectomy were enrolled in the study. The patients were randomly divided into Group A (intercostal nerve cryoanalgesia) and Group B (parecoxib). The analgesic and adverse effects were compared between the two groups. The pain score of Group A was significantly lower than that of Group B (P < 0.05). The patients in Group A used significantly less morphine than those in Group B (P < 0.05). There were also significantly fewer complications in Group A than in Group B (P < 0.05). Cryoanalgesia of the intercostal nerves can be considered an economical, safe and simple technique for the long-term management of post-lobectomy pain.

[The study on freezing intercostal nerves for the relief of postoperative chest pain].

OBJECTIVE: To explore the best freezing time and the optimum analgesia modality. METHODS: In dogs, intercostal nerves were froze at -70 degrees C at different time including 30, 60, 90, 120, 180 s. Samples were got at the operative day, in 10 days and 60 days respectively, then carried on the pathology exam. In clinical study, 150 patients undergoing thoracotomy were randomly designated into 5 groups, all patients were recorded the heart rate, blood pressure, SO2, VAS, the dosage of dolantin, and observed the complications and side effects. RESULTS: At operative day, the freezing nerves appeared brown print macroscopically, and presented degeneration, necrosis of the nerve fiber microscopically with more than 90 s. After 10 days, nerves with more than 90 s became thinner than normal. After 60 days, all nerves had no obvious differentiation than normal. In clinical study, both 90 s group and 90 s with PCIA group were significantly better than 60 s group or PCIA group; The VAS of 90 s with PCIA group was significantly lower than 90 s group but had more side effects such as vomiting, nausea. CONCLUSIONS: At -70 degrees C, the freezing time should be no less than 90 s. The freezing intercostal nerves can safely and effectively relieve postoperative chest pain. The effect of analgesia of 90 s with PCIA group is the best, but has many side effects.