Plastic and reconstructive surgery. Global open
October 20, 2026 · via Europe PMC
Peripheral Nerve Stimulation Reduces Opioid Use and Facilitates Early Ambulation Following Fibular Flap Harvest: A Retrospective Study.
Choi KJ, Posis AIB, Costanzo A, Scherschel A, Qualliotine JR, Ortiz-Pomales YT, O'Reilly E, Hammer DA.
AI summary — for doctors, generated from the abstract only
Peripheral nerve stimulation after fibular flap harvest was associated with lower pain scores and possibly less opioid use.
What was studied
Retrospective single-center comparison of 26 fibular free flap patients receiving multimodal analgesia alone versus with peroneal nerve temporary percutaneous nerve stimulation.
Key findings
- Pain scores were significantly lower on postoperative days 2-5 with stimulation.
- Time to independent ambulation was shorter (3.71 vs 4.76 days) but not significant (P = 0.24).
- The authors suggest it is a safe opioid-sparing adjunct (opioid result figures are cut off).
Clinical relevance
A motor-sparing, nonopioid option for donor-site pain after fibular flap harvest.
Who should care
Limitations
Very small retrospective cohorts with potential confounding and non-significant key secondary outcomes.
Consider nerve stimulation as an adjunct while awaiting prospective trials.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Fibular free flap (FFF) reconstruction is the gold standard for mandibular and maxillary defects, but donor-site pain remains challenging. Multimodal analgesia (MMA) relies on opioids, which risk dependence, systemic side effects, and delayed recovery. Regional nerve blocks reduce pain but have inconsistent efficacy owing to variable drug metabolism, potential effects on flap perfusion, and motor blockade. Temporary percutaneous peripheral nerve stimulation (TPNS) is a promising alternative that selectively modulates sensory pathways while preserving motor function.
Methods
This retrospective, single-center study evaluated 26 patients who underwent FFF reconstruction between July 2021 and November 2025, divided into 2 cohorts: MMA alone and MMA with peroneal nerve TPNS. The primary outcome was opioid consumption, expressed as oral morphine equivalents. Secondary outcomes were postoperative pain scores, time to independent ambulation, and length of stay.
Results
The TPNS group had significantly lower pain scores on postoperative days 2-5 (P P = 0.1), as was median time to independent ambulation (3.71 versus 4.76 d; P = 0.24).
Conclusions
TPNS may be a safe, opioid-sparing adjunct that promotes earlier mobilization after FFF harvest. Further study is needed to justify prospective, multicenter trials validating efficacy, cost-effectiveness, and broader applicability in head and neck reconstructive surgery.
DOI
10.1097/gox.0000000000008167
PMID
42903310
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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