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Mil Med. 2019 Mar 1;184(Suppl 1):557-564. doi: 10.1093/milmed/usy378.

Percutaneous Peripheral Nerve Stimulation to Control Postoperative Pain, Decrease Opioid Use, and Accelerate Functional Recovery Following Orthopedic Trauma.

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University of California San Diego, 200 W Arbor Drive, San Diego, CA.
Johns Hopkins School of Medicine, Department of Anesthesiology and Critical Care Medicine, 1800 Orleans Street, Baltimore, MD.
Medical College of Georgia, Department of Anesthesiology & Perioperative Medicine, BIW-2144 1120 15th Street, Augusta, GA.
Naval Medical Center San Diego, Department of Anesthesiology, 34800 Bob Wilson Dr, San Diego, CA.
SPR Therapeutics, 22901 Millcreek Boulevard, Suite 110, Cleveland, OH.


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) - and 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.


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

[Available on 2020-03-01]
[Indexed for MEDLINE]

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