Peripheral Nerve Stimulation Provides an Alternative to Opioids for Post-Amputation Pain

Newswise — As clinicians seek to reduce the use of opioids in surgical pain management, temporary percutaneous peripheral nerve stimulation (PNS) devices are a promising alternative. In this procedure, a tiny device is implanted and delivers an electric impulse to the nerve, interrupting pain signals. These devices are now being explored for the treatment of pain following major limb amputation, where traditional treatment includes local anesthetics and oral pain medications, which are often ineffective and have unwanted side effects. A new pilot study led by primary investigator Dr. Denise Lester looked at the feasibility of introducing the PNS device as early as 5-7 days after amputation.

Brooke Albright-Trainer, Thomas Phan, Robert Trainer, Nathan D. Crosby, Douglas Murphy, Peter Disalvo, and Denise Lester of Central Virginia VA Health Services Center, Richmond, VA, received a Best of Meeting Abstract Award from the American Society of Regional Anesthesia and Pain Medicine (ASRA) for its 46th Annual Regional Anesthesiology and Acute Pain Medicine Meeting, being held May 13-15, 2021. The authors will present Abstract #1968, “A Randomized Controlled Feasibility Trial of Peripheral Nerve Stimulation for Acute and Subacute Post-Amputation Pain,” on Saturday, May 15.

In the pilot study, PNS devices targeting both the femoral and sciatic nerves were placed before patients left the hospital. The results showed that patients undergoing lower body amputations who received PNS implants were able to be discharged home or to rehab earlier with better pain control, required fewer opioids overtime, and were less likely to be readmitted to the hospital in 30 days. 

 “We feel the results of this pilot are promising and hope this study demonstrates that placement of these devices within one week of amputation is possible and may be beneficial,” Lester said. “Larger randomized controlled studies are needed to further evaluate these benefits, but the future is exciting for amputees!”