Back to Search
Start Over
Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Femoral Nerve for Postoperative Analgesia Following Ambulatory Anterior Cruciate Ligament Reconstruction: A Proof of Concept Study
- Source :
- Ilfeld, Brian M; Said, Engy T; Finneran, John J; Sztain, Jacklynn F; Abramson, Wendy B; Gabriel, Rodney A; et al.(2018). Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Femoral Nerve for Postoperative Analgesia Following Ambulatory Anterior Cruciate Ligament Reconstruction: A Proof of Concept Study.. Neuromodulation : journal of the International Neuromodulation Society. doi: 10.1111/ner.12851. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/4089w7jr, Neuromodulation : journal of the International Neuromodulation Society, vol 22, iss 5
- Publication Year :
- 2018
- Publisher :
- eScholarship, University of California, 2018.
-
Abstract
- ObjectivesThe purpose of this prospective proof of concept study was to investigate the feasibility of using percutaneous peripheral nerve stimulation of the femoral nerve to treat pain in the immediate postoperative period following ambulatory anterior cruciate ligament reconstruction with a patellar autograft.Materials and methodsPreoperatively, an electrical lead (SPRINT, SPR Therapeutics, Inc., Cleveland, OH, USA) was percutaneously implanted with ultrasound guidance anterior to the femoral nerve caudad to the inguinal crease. Within the recovery room, subjects received 5 min of either stimulation or sham in a randomized, double-masked fashion followed by a 5-min crossover period, and then continuous active stimulation until lead removal postoperative Day 14-28. Statistics were not applied to the data due to the small sample size of this feasibility study.ResultsDuring the initial 5-min treatment period, subjects randomized to stimulation (n = 5) experienced a slight downward trajectory (decrease of 7%) in their pain over the 5 min of treatment, while those receiving sham (n = 5) reported a slight upward trajectory (increase of 4%) until their subsequent 5-min stimulation crossover, during which time they also experienced a slight downward trajectory (decrease of 11% from baseline). A majority of subjects (80%) used a continuous adductor canal nerve block for rescue analgesia (in addition to stimulation) during postoperative Days 1-3, after which the median resting and dynamic pain scores remained equal or less than 1.5 on the numeric rating scale, respectively, and the median daily opioid consumption was less than 1.0 tablet.ConclusionsThis proof of concept study demonstrates that percutaneous femoral nerve stimulation is feasible for ambulatory knee surgery; and suggests that this modality may be effective in providing analgesia and decreasing opioid requirements following anterior cruciate ligament reconstruction. clinicaltrials.gov: NCT02898103.
- Subjects :
- Adult
Male
Clinical Sciences
percutaneous peripheral nerve stimulation
Pain
Proof of Concept Study
Double-Blind Method
Clinical Research
Humans
Prospective Studies
Postoperative
Electrodes
Ultrasonography
Pain Measurement
Cross-Over Studies
Neurology & Neurosurgery
Interventional
Anterior Cruciate Ligament Reconstruction
outpatient surgery
Pain Research
Rehabilitation
Ambulatory surgery
Neurosciences
postoperative analgesia
Ambulatory Surgical Procedures
neuromodulation
Transcutaneous Electric Nerve Stimulation
Cognitive Science
Female
Cognitive Sciences
Implanted
Patient Safety
Analgesia
Chronic Pain
Femoral Nerve
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Ilfeld, Brian M; Said, Engy T; Finneran, John J; Sztain, Jacklynn F; Abramson, Wendy B; Gabriel, Rodney A; et al.(2018). Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Femoral Nerve for Postoperative Analgesia Following Ambulatory Anterior Cruciate Ligament Reconstruction: A Proof of Concept Study.. Neuromodulation : journal of the International Neuromodulation Society. doi: 10.1111/ner.12851. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/4089w7jr, Neuromodulation : journal of the International Neuromodulation Society, vol 22, iss 5
- Accession number :
- edsair.dedup.wf.001..257a76f67f14dd44f36c49f45a27e046