Purpose of Review

Analgesic hot and cold temperatures have been used for both conservative and ablative therapies for millennia. There are well-known locoregional neurovascular changes associated with the application of heat or ice in the literature and in practice. The oscillation between heat and cold has recently been identified as a synergistic mechanism of action with early translational results in humans.

Recent Findings

Recent mechanistic work in the feline model has demonstrated that a reliable, reversible nerve block can be achieved within a temperature range that is non-destructive (15–45°C). The underlying mechanism is a newly described hysteresis in the responsiveness of peripheral nerves to alternating thermal stimuli resulting in nerve blockade. Recently presented feasibility data reports positive results in subjects with occipital pain and peripheral scar pain in terms of pain and associated symptom improvement.

Summary

Temperature-mediated changes in pain and sensation have been observed for hot and cold applications at a variety of temperatures. Recent insights into the synergy between preheating followed by cooling resulting in peripheral nerve fiber block has potential in a variety of conditions in which peripheral nerve etiology is noted. Recent findings in chronic headache patients report decreased pain and symptom improvement. Further studies are ongoing to understand the indications for this novel therapy.

中文翻译：

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温度介导的神经阻滞治疗疼痛

审查目的

数千年来，热镇痛和冷热镇痛已被用于保守疗法和消融疗法。在文献和实践中，有众所周知的局部神经血管变化与热或冰的应用相关。冷热之间的振荡最近被确定为与人类早期转化结果的协同作用机制。

最近的发现

最近对猫科动物模型的机械研究表明，可以在非破坏性温度范围 (15–45°C) 内实现可靠、可逆的神经阻滞。潜在的机制是新描述的外周神经对交替热刺激的反应迟滞，导致神经阻滞。最近提交的可行性数据报告了在疼痛和相关症状改善方面对枕部疼痛和外周疤痕疼痛患者的积极结果。

概括

对于在各种温度下的冷热应用，已经观察到温度介导的疼痛和感觉变化。最近对预热和冷却之间的协同作用导致周围神经纤维阻滞的见解在注意到周围神经病因的各种情况下具有潜力。最近在慢性头痛患者中的发现报告了疼痛减轻和症状改善。正在进行进一步的研究以了解这种新型疗法的适应症。