Peripheral nerve stimulation for the management of acute and subacute post-amputation pain: a randomized, controlled feasibility trial

• Published in: Pain management (London) 2022-04, Vol.12 (3), p.357-369
• Main Authors: Albright-Trainer, Brooke, Phan, Thomas, Trainer, Robert J, Crosby, Nathan D, Murphy, Douglas P, Disalvo, Peter, Amendola, Michael, Lester, Denise D
• Format: Article
• Language: English
• Subjects: leg amputation surgery; neuromodulation; opioids; peripheral nerve stimulation; phantom limb pain; residual limb pain
• ISSN: 1758-1869; 1758-1877
• DOI: 10.2217/pmt-2021-0087

Temporary (60-day) percutaneous peripheral nerve stimulation (PNS) has demonstrated effectiveness for the treatment of chronic post-amputation pain, and this pilot study aims to evaluate the feasibility of temporary percutaneous PNS for the treatment of acute post-amputation pain. Sixteen veterans undergoing lower extremity amputation received PNS and standard medical therapy or standard medical therapy alone. The PNS group reported greater reductions in average phantom limb pain, residual limb pain and daily opioid consumption, and there were fewer participants taking opioids through 3 months post-amputation. This pilot study suggests that PNS is feasible in the acute postoperative period following lower limb amputation and may provide a non-pharmacologic analgesic therapy that lowers pain scores and reduces opioid consumption, and thus warrants further investigation. A small study was done to evaluate placing a wire lead near a nerve to electrically stimulate it for 60 days after a leg amputation surgery to see if it helps reduce pain. The study looked at 16 veterans who had an amputation to their leg. These patients were divided into either a group that received nerve stimulation plus normal pain control medications or a group that just received pain medications. The group that received nerve stimulation had less pain in the remaining leg and less phantom pain (pain in the missing leg). They also required fewer narcotic medications. The study suggested that nerve stimulation may provide an effective way to manage pain after amputation and reduce the use of pain medications.