Auricular Field Nerve Stimulation using the NSS-2 BRIDGE® Device as an Alternative to Opioids Following Kidney Donor Surgery

Jacques E. Chelly f) B, Amy L. Monroe, Raymond M. Planinsic, Amit Tevar and Brittany E. Norton, From the Journal of Complementary and Integrative Medicine

Abstract

Objectives

The purpose of this study was to investigate the role that the NSS-2 BRIDGE® device, an auricular field nerve stimulator, may play in reducing opioid requirement and pain in kidney donor surgery. It was not a randomized study. Electrophysiologic studies have demonstrated that the stimulation of the cranial nerves produced by the NSS-2 BRIDGE® device modulates the ascending/descending spinal pain pathways, especially at the level of the limbic system.

Methods

The design compared the effects of the NSS-2 BRIDGE® device (NSS 2-BRIDGE® device group; n= 10) to a control group (n= 10). In both groups, the surgery was performed using the same standard enhanced recovery after surgery protocol based on the use of a multimodal analgesic approach. For the active treatment group, the NSS-2 BRIDGE® device was placed in the post anesthesia care unit. The primary endpoint was opioid requirement (oral morphine equivalent, OME in mg) at 24 h post-surgery. Secondary endpoints included pain (0-10), at 24 and 48 h, time to discharge from the recovery room, incidence of post-operative nausea and vomiting at 24 h, time to oral intake, time to ambulation, and time to discharge from the hospital. Data was analyzed using unpaired t-test and presented as mean± standard deviation.

Results

Compared to control, the use of the NSS-2 BRIDGE® was associated with a 75.4% reduction in OME (33.6 vs. 8.3 mg; p=0.03) and 41.5% reduction in pain (5 vs. 3.28; p=0.06) at 24 h and a 73.3% difference in pain at 48 h ( 1.6 ± 1.6 vs. 6.0 ± 2.8; p=0.0004 ). There was no difference in non-opioid analgesics administration between groups.

Conclusions

The tolerability of NSS-2 BRIDGE® device was reported by most to be excellent. This study suggests that the NSS-2 BRIDGE® device may represent a complementary approach for controlling postoperative opioid consumption and pain in patients undergoing kidney donation.

Keywords: anesthesiology; auricular neurostimulation; auriculotherapy; nephrectomy donor; opioids; pain management