The Evolving Role of Peripheral Nerve Stimulation in Postoperative Analgesia and Recovery

Acute postoperative pain has traditionally been managed with opioids and regional nerve blocks, both of which are associated with limitations including drug-related adverse effects and motor blockade. This narrative review evaluates temporary percutaneous peripheral nerve stimulation (PNS) as an advanced, opioid- and motor-sparing neuromodulation strategy for postoperative pain management.

Temporary PNS selectively targets sensory afferent fibers to provide immediate nociceptive inhibition while promoting neuroplastic changes that reverse central sensitization, resulting in sustained analgesia beyond device removal. Unlike regional anesthesia, temporary PNS preserves motor function, facilitating early mobilization and rehabilitation. Clinical evidence across multiple surgical specialties demonstrates that 14- to 60-day temporary PNS significantly reduces postoperative pain scores and cumulative opioid consumption while maintaining a favorable safety profile, with adverse events primarily limited to mild insertion-site reactions. Temporary percutaneous PNS represents an important advancement in postoperative pain management by providing targeted analgesia without motor impairment or opioid-related adverse effects. Its ability to support Enhanced Recovery After Surgery (ERAS) pathways while potentially reducing the risk of persistent postsurgical pain highlights its growing clinical value. Further studies are needed to optimize stimulation parameters, refine patient selection, and determine its long-term role in preventing the transition from acute to chronic postsurgical pain.