Peripheral nerve stimulation may reduce pain and opioid need after orthopedic surgery: Study

USA: Postoperative percutaneous peripheral nerve stimulation (PPNS) after ambulatory orthopedic surgery reduced pain and opioid requirements without side effects during at least the initial week, a recent study has found. The findings of the study are published in the journal Anesthesiology.

PPNS is an analgesic technique in which a lead is implanted percutaneously followed by the delivery of electric current using an external pulse generator. It has been used extensively for chronic pain, but for acute postoperative pain, only uncontrolled series have been published. Brian M. Ilfeld and colleagues undertook this multicenter study to (1) determine the feasibility and optimize the protocol for a subsequent clinical trial and (2) estimate the treatment effect of percutaneous peripheral nerve stimulation on postoperative pain and opioid consumption.

For this purpose, the researchers percutaneously implanted an electrical lead preoperatively to target the sciatic nerve for major foot/ankle surgery (e.g., hallux valgus correction), the femoral nerve for anterior cruciate ligament reconstruction, or the brachial plexus for rotator cuff repair, followed by a single injection of long-acting local anesthetic along the same nerve/plexus. Postoperatively, participants were randomized to receive either electrical stimulation (n = 32) or sham stimulation (n = 34) using an external pulse generator in a double-masked fashion for 14 days.