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Case Reports
. 2024 Jun 11;16(6):e62142.
doi: 10.7759/cureus.62142. eCollection 2024 Jun.

Peripheral Nerve Stimulation for Treating Acute Pain Following Traumatic Fracture: A Case Report of Rapid-Onset Analgesia Without Motor Blockade

Ammar Siddiqui  1 , Nitin Sekhri  1 , Irim Salik  1 , Fang Yu  2 , Jeff L Xu  1
Affiliations
Case Reports

Peripheral Nerve Stimulation for Treating Acute Pain Following Traumatic Fracture: A Case Report of Rapid-Onset Analgesia Without Motor Blockade

Ammar Siddiqui et al. Cureus. .

Abstract

Analgesia following acute traumatic fracture remains a clinical challenge. Pain relief via peripheral nerve stimulation (PNS) is a promising treatment modality due to its opioid-sparing effects and rapid, reversible sensory blockade without motor blockade. We present the case of a patient who suffered a traumatic tibial plateau fracture. A popliteal sciatic PNS device was placed on postoperative day 1 following inadequate pain control. The patient reported marked pain relief, a significant reduction in morphine milligram equivalent (MME) utilization, and improved early functional recovery. The PNS lead was removed at the patient's 2-month follow-up visit without any adverse events.

Keywords: motor blockade sparing; nerve blockade; peripheral nerve stimulation; rapid-onset analgesia; traumatic fracture.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Images of peripheral nerve stimulation (PNS) placement
Figure 1: (A) Postoperative X-ray imaging following open reduction and internal fixation of the tibial plateau fracture, (B) Ultrasound-guided needle/electrode placement for PNS placement, and (C) the PNS system a: Sciatic Nerve, b: Needle
Figure 2
Figure 2. Post-PNS placement pain score and opioid usage
Figure 2: Post PNS placement Numeric Rating Scale (NRS) scores and oral Morphine Milligram Equivalent (MME) over time.
See this image and copyright information in PMC

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