Percutaneous peripheral nerve stimulation reduces acute pain and opioid requirements in the week following orthopedic surgery, according to a pilot study published in Anesthesiology. Researchers assessed the feasibility and optimal protocol of percutaneous peripheral nerve stimulation for postoperative pain and opioid consumption. An electrical lead was percutaneously implanted preoperatively to target the sciatic nerve for major foot/ankle surgery, 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. Participants were randomly assigned to 14 days of either electrical stimulation (32 patients) or sham stimulation (34 patients) using an external pulse generator. During the first 7 postoperative days, opioid consumption in participants given active stimulation was a median of 5 mg, versus 48 mg in patients given sham treatment. The average pain intensity in patients given active stimulation was a mean of 1.1 versus 3.1 in those given sham in the first 7 postoperative days. “Percutaneous peripheral nerve stimulation reduced pain scores and opioid requirements free of systemic side effects during at least the initial week after ambulatory orthopedic surgery,” the authors write.
