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E-Poster Viewing Abstracts
E-Poster Viewing – Postoperative Pain Management
ESRA19-0419 Percutaneous electrical nerve block of acute pain in humans
  1. A Soin1,
  2. B Winchester2,
  3. R Caldwell3,
  4. E Dewenter1,
  5. N Alexeeva3,
  6. W Liu3,
  7. P Schorr3,
  8. S Sastry3 and
  9. E Schepis3
  1. 1Ohio Pain Clinic, Anesthesiology, Dayton, USA
  2. 2San Francisco Surgery Center, Anesthesiology, San Francisco, USA
  3. 3Avanos Medical, Research and Development, Alpharetta, USA

Abstract

Background and aims High-frequency electrical stimulation (HFES) delivered to a peripheral nerve through implanted electrodes can reduce chronic pain. However, surgical placement burdens the use of HFES for acute applications. We investigated the effects of HFES delivered percutaneously to a sensory nerve on acute pain elicited in able-bodied (AB) subjects, and on post-surgical pain in one subject within 24 hours of total knee arthroplasty (TKA).

Methods High-frequency electrical stimulation (sinewave; 10 kHz; ≤ 25 mA) was delivered to the saphenous nerve at the adductor canal via a percutaneous lead in 5 AB and 1 TKA subjects. Acute pain sensations in AB subjects were elicited by transcutaneous electrical stimulation of the saphenous nerve at the ankle. Subjective sensations (11-point scale, with 3 corresponding to pain-threshold), pain scores (NRS), and muscle activity were recorded. The study was approved by Copernicus IRB.

Results All subjects reported reduced pain scores in response to HFES. In able-bodied subjects, painful sensations were either completely abolished (N=4; figure 1a) or reduced (N=1; figure 1b). Post-surgical pain in the TKA subject was reduced from 6.5 to 2.5 on NRS. Pain scores in all 6 subjects returned to baseline values within seconds-to-minutes after the stimulation was terminated. High-frequency electrical stimulation did not elicit EMG activity or visible contractions of the thigh muscles. No serious adverse effects were reported.

Abstract ESRA19-0419 Figure 1
Abstract ESRA19-0419 Figure 1

The HFES effects on acute pain elicited in 2 AB subjects. Subjective sensation (middle trace) were measured using an 11-points scale, where 3 indicated pain-threshold. Intensity of electrical nerve stimulation at the ankle and HFES of the saphenous nerve at the aductor canal are shown in upper, and lower traces , respectively.

Conclusions Percutaneous high-frequency electrical stimulation of the saphenous nerve in the adductor canal can reversibly block acute pain sensations in humans, without causing co-excitation of nearby muscles.

https://doi.org/10.1136/rapm-2019-ESRAABS2019.416

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