Peripheral Nerve Stimulation: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
This article provides a comprehensive overview of peripheral nerve stimulation (PNS), including preparation, procedure, recovery, risks, and aftercare.
What is Peripheral Nerve Stimulation?
Using peripheral nerve stimulation, small electrodes are placed near peripheral nerves that transmit pain signals to the brain. By interrupting pain signals with electrical impulses, these electrodes are connected to an implantable device like a pacemaker, which provides relief to the patient.
Overview of Peripheral Nerve Stimulation
PNS is typically recommended for individuals suffering from chronic pain conditions that have not responded to conservative treatments such as medications, physical therapy, or injections. Neuropathy pain, complex regional pain syndrome (CRPS), and peripheral nerve injuries are common conditions treated with PNS.
Preparation for Peripheral Nerve Stimulation
The patients are evaluated by a pain management specialist to determine if they are suitable candidates before undergoing PNS. Medical history, physical examination, diagnostic imaging, and psychological assessment may all be part of this evaluation. To reduce the risk of bleeding, certain medications, such as blood thinners, should be discontinued days before the procedure.
The Procedure
Under local anesthesia or sedation, peripheral nerve stimulation is typically performed as an outpatient procedure. In order to accurately place the electrodes near the targeted peripheral nerves, the pain management specialist uses fluoroscopic guidance. Once the electrodes are in position, they are connected to the implantable pulse generator (IPG), which is usually implanted in the buttock or abdomen. Depending on the patient's pain, the IPG delivers electrical impulses at specific frequencies and intensities.
Recovery Process
After the procedure, patients are monitored in a recovery area for a brief period before being discharged home. Mild discomfort or soreness at the implantation site is common and can usually be managed with over-the-counter pain medications. It is advised that patients avoid strenuous activity for a few weeks in order to allow the electrodes and IPG to settle in. Follow-up appointments are scheduled to monitor the patient's response to the treatment and adjust the settings as necessary.
Risks and Complications
There are potential risks and complications associated with peripheral nerve stimulation, despite its general safety. It is possible to experience infection, bleeding, lead migration, breakage, allergic reactions to materials used, discomfort, or dissatisfaction with the results of the treatment. Prior to undergoing PNS, patients should discuss these risks with their pain management specialist.
Aftercare Instructions
For optimal results and minimal complications, patients receive aftercare instructions after peripheral nerve stimulation. It is important to keep the incision site dry and clean, avoid direct pressure on the implant site, and gradually return to normal activities after surgery. To keep track of their symptoms and to report any changes or concerns to their healthcare provider promptly, patients are advised to keep a pain diary.
Conclusion
Chronic pain sufferers who have not been able to benefit from other treatments can benefit from peripheral nerve stimulation. Patients can make informed decisions about whether PNS is right for them if they understand the preparation, procedure, recovery, risks, and aftercare involved. In order to improve quality of life and achieve the best possible outcome, it is essential to work with a pain management specialist.
