High-Frequency Electric Nerve Block to Treat Postamputation Pain

Abstract

The use of peripheral nerve stimulation (PNS) has been a part of neuromodulation for over three decades. Initially, the therapy was offered by a very invasive method involving a cut down to the nerve and the placement of a large paddle lead directly adjacent to the nerve fibers. This method fell out of favor, as the low-frequency stimulation sometimes caused pain with nerve activation, or a lack of stimulation occurred secondary to increasing impedance. In recent years, the use of PNS with percutaneous leads has changed the situation: With the advent of improved programming and platforms, the implanting doctor can create pain relief by placing a lead in the area near the nerve by landmarks, ultrasound, or nerve stimulation. This method has been more successful, but new solutions are still needed to treat patients with severe pain of the limb after trauma. This chapter illustrates an option to treat postamputation pain using high-frequency (10 kHz) electrical nerve block via a surgically implanted, minimally invasive peripheral nerve cuff electrode.