Chapter 60 - Percutaneous Peripheral Nerve Stimulation for the Management of Postoperative Pain

Abstract

Moderate to severe postoperative pain is frequently experienced following surgery. Percutaneous peripheral nerve stimulation (PNS) is an alternative method of pain control involving the insertion of an electrical lead through an introducing needle—obviating an open surgical incision for placement—followed by the introduction of electric current to produce analgesia. This temporary therapy has multiple theoretical benefits over existing analgesics, such as a lack of systemic side-effects (e.g., nausea, respiratory depression), an absence of induced muscle weakness, and a reduced risk of adverse events (e.g., infection). Early data from nonrandomized feasibility studies suggests that percutaneous PNS can provide immediate clinically significant pain relief in subjects suffering from postoperative pain following total knee arthroplasty, a surgical procedure with one of the highest rates of severe and prolonged postoperative pain.