title: Neurostimulation for Postsurgical Analgesia: A Novel System Enabling Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation.
abstract: While neurostimulation-stimulation of the nervous system using electrical current-has been used to treat chronic pain, its use treating postsurgical pain has been limited. Here, we report on the clinical application of a novel investigational lead to provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously using ultrasound guidance within 0.5 to 3.0 cm of the femoral and/or sciatic nerve(s). With the delivery of current, pain decreased an average of 63% at rest, with 4 of 5 subjects having relief of > 50%. During passive and active knee flexion, pain decreased an average of 14% and 50%, with 0/3 and 1/2 subjects attaining > 50% relief, respectively. Ultrasound-guided percutaneous peripheral nerve stimulation may be a practical modality for the treatment of postsurgical pain.
authors.affiliation: Department of Anesthesiology, University of California San Diego, San Diego, California, U.S.A.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Ilfeld
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, U.S.A.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Grant
authors.affiliation: Department of Anesthesiology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, U.S.A.|The Center for Clinical Research, Winston-Salem, North Carolina, U.S.A.|Carolinas Pain Institute, Winston-Salem, North Carolina, U.S.A.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Gilmore
authors.affiliation: Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio, U.S.A.|Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, U.S.A.|MetroHealth Rehabilitation Institute, MetroHealth System, Cleveland, Ohio, U.S.A.|Cleveland Functional Electrical Stimulation Center, Cleveland, Ohio, U.S.A.
authors.forename: John
authors.initials: J
authors.lastname: Chae
authors.affiliation: Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio, U.S.A.|MetroHealth Rehabilitation Institute, MetroHealth System, Cleveland, Ohio, U.S.A.|Cleveland Functional Electrical Stimulation Center, Cleveland, Ohio, U.S.A.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Wilson
authors.affiliation: SPR Therapeutics, Chapel Hill, North Carolina, U.S.A.
authors.forename: Amorn
authors.initials: A
authors.lastname: Wongsarnpigoon
authors.affiliation: SPR Therapeutics, Chapel Hill, North Carolina, U.S.A.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Boggs
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D000075082:Proof of Concept Study; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: helical lead; neuromodulation; percutaneous peripheral nerve stimulation; peripheral nerve stimulator; postoperative pain; small-diameter open-coiled helical lead