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

被引:21
作者
Ilfeld, Brian M. [1 ]
Ball, Scott T. [1 ]
Cohen, Steven P. [2 ]
Hanling, Steven R. [3 ]
Fowler, Ian M. [4 ]
Wongsarnpigoon, Amorn [5 ]
Boggs, Joseph W. [5 ]
机构
[1] Univ Calif San Diego, 200 W Arbor Dr, San Diego, CA 92103 USA
[2] Johns Hopkins Sch Med, Dept Anesthesiol & Crit Care Med, 1800 Orleans St, Baltimore, MD 21287 USA
[3] Med Coll Georgia, Dept Anesthesiol & Perioperat Med, BIW 2144 1120 15th St, Augusta, GA 30912 USA
[4] Naval Med Ctr San Diego, Dept Anesthesiol, 34800 Bob Wilson Dr, San Diego, CA 92134 USA
[5] SPR Therapeut, 22901 Millcreek Blvd,Suite 110, Cleveland, OH 44122 USA
基金
美国国家卫生研究院;
关键词
Postsurgical pain; neurostimulation; non-opioid; total joint replacement; TOTAL KNEE ARTHROPLASTY; HEMIPLEGIC SHOULDER PAIN; OPERATION IRAQI FREEDOM; TOTAL HIP; ELECTRICAL-STIMULATION; INTRAMUSCULAR ELECTRODES; DISABILITY; OSTEOARTHRITIS; OUTCOMES; RISK;
D O I
10.1093/milmed/usy378
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 therapypercutaneous 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.
引用
收藏
页码:557 / 564
页数:8
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