Evidence map›Paper›PMID 38388019›Full record

Trial reportRegional anesthesia and pain medicine2025

Percutaneous auricular neuromodulation (nerve stimulation) for the treatment of pain following total knee arthroplasty: a randomized, double-masked, sham-controlled pilot study.

Brian M Ilfeld, John J Finneran, Brenton Alexander, Wendy B Abramson, Jacklynn F Sztain, Scott T Ball, Francis B Gonzales, Baharin Abdullah, Brannon J Cha, Engy T Said

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Regional anesthesia and pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05521516 nacompletednot on this map

Percutaneous Auricular Neuromodulation for Postoperative Analgesia: A Randomized, Participant- and Observer-Masked, Sham-Controlled Pilot Study

TypeinterventionalSponsorUniversity of California, San DiegoRan2022 to 2024Enrolled122ConditionsPostoperative Pain, AcuteArmsActive Percutaneous Auricular Neuromodulation with NSS-2 Bridge, Sham Treatment
NCT07394647 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Transcutaneous Auricular Vagus Nerve Stimulation for Preventing Emergence Agitation and Delirium After Pediatric Tonsillectomy and Adenoidectomy: A Randomized, Double-Blind, Interventional Study

TypeinterventionalSponsorThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityRan2026 to 2026Enrolled120ConditionsEmergence Agitation, Emergence DeliriumArmsActive taVNS Group, Sham stimulation group
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Brian M IlfeldDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA bilfeld@health.ucsd.edu.ORCID 0000-0002-6144-3273
John J FinneranDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-0955-155X
Brenton AlexanderDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.ORCID 0000-0003-3657-0673
Wendy B AbramsonDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.
Jacklynn F SztainDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.
Scott T BallDepartment of Orthopedic Surgery, University California San Diego, San Diego, California, USA.
Francis B GonzalesDepartment of Orthopedic Surgery, University California San Diego, San Diego, California, USA.
Baharin AbdullahDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.
Brannon J ChaDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.
Engy T SaidDepartment of Anesthesiology, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-7897-1670
University of California San Diego · USCleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous auricular nerve stimulation (neuromodulation) is an analgesic technique involving the percutaneous implantation of multiple leads at various points on/around the ear followed by the delivery of electric current using an external pulse generator. A device is currently available within the USA cleared to treat symptoms from opioid withdrawal, and multiple reports suggest a possible postoperative analgesic effect. The current randomized, controlled pilot study was undertaken to (1) determine the feasibility and optimize the protocol for a subsequent definitive clinical trial and (2) estimate the treatment effect of auricular neuromodulation on postoperative pain and opioid consumption following total knee arthroplasty.

methodsWithin the recovery room following primary, unilateral, total knee arthroplasty, an auricular neuromodulation device (NSS-2 Bridge, Masimo, Irvine, California, USA) was applied using three percutaneous leads and one ground electrode. Participants were randomized to 5 days of either electrical stimulation or sham stimulation in a double-masked fashion. Participants were discharged with the stimulator

resultsDuring the first five postoperative days, oxycodone consumption in participants given active stimulation (n=15) was a median (IQR) of 4 mg (2-12) vs 13 mg (5-23) in patients given sham (n=15) treatment (p=0.039). During this same period, the average pain intensity in patients given active stimulation was a median (IQR) of 2.5 (1.5-3.3) vs 4.0 (3.6-4.8) in those given sham (p=0.014). Awakenings due to pain over all eight postoperative nights in participants given active stimulation was a median (IQR) of 5 (3-8) vs 11 (4-14) in those given sham (p<0.001). No device-related localized cutaneous irritation, systemic side effects, or other adverse events were identified.

conclusionsPercutaneous auricular neuromodulation reduced pain scores and opioid requirements during the initial week after total knee arthroplasty. Given the ease of application as well as the lack of systemic side effects and reported complications, a definitive clinical trial appears warranted. TRIAL REGISTRATION NUMBER: NCT05521516.

Indexed as

Arthroplasty, Replacement, KneePostoperative PainTranscutaneous Electric Nerve StimulationAgedAnalgesics, OpioidDouble-Blind MethodFemaleHumansMaleMiddle AgedPain MeasurementPilot ProjectsTreatment OutcomeAnalgesics, OpioidanalgesiaPain, PostoperativePostoperative Pain

Identifiers

PMID38388019
PMCPMC11877037
OpenAlexW4392086321

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.