Percutaneous peripheral nerve stimulation to control postoperative pain, decrease opioid use, and accelerate functional recovery following orthopedic trauma

Brian M. Ilfeld, Scott T. Ball, Steven Cohen, Steven R. Hanling, Ian M. Fowler, Amorn Wongsarnpigoon, Joseph W. Boggs

Research output: Contribution to journalArticlepeer-review

Abstract

Orthopedic trauma is a significant military problem, causing several of the most disabling conditions with high rates of separation from duty and erosion of military readiness. The objective of this report is to summarize the findings of case series of a non-opioid therapy-percutaneous peripheral nerve stimulation (PNS)- A nd describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9). The orthopedic trauma induced during TKR is highly representative of multiple types of orthopedic trauma sustained by Service members and frequently produces intense, prolonged postoperative pain and extended opioid use following surgery. Collectively, the results of these three clinical studies demonstrated that percutaneous PNS can provide substantial pain relief, reduce opioid use, and improve function. These outcomes suggest that there is substantial potential for the use of percutaneous PNS following orthopedic trauma.

Original languageEnglish (US)
Pages (from-to)557-564
Number of pages8
JournalMilitary medicine
Volume184
DOIs
StatePublished - Mar 1 2019

Keywords

  • neurostimulation
  • non-opioid
  • Postsurgical pain
  • total joint replacement

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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