Complementary therapies including nonopioid analgesics and regional anesthesia are prevalent in the management of acute pain due to the opioid epidemic in North America. The therapy which has recently got attention is Neurostimulation. Neurostimulation is in use for many years as an analgesic modality, for the treatment of different types of acute and chronic pain states. But, the availability of technologies previously has restricted its widespread use. Percutaneous peripheral nerve stimulation (pPNS) is the latest way suggested that can help manage acute postoperative pain following total knee arthroplasty 

A review was conducted to evaluate the current literature concerned with the use of pPNS and its role in the management of acute pain. Several recent studies revealed the successful perineural placement of stimulating electrodes under ultrasound guidance. Simultaneous advancement in manufacturing technology of lead and stimulator has made it easier to utilize neurostimulation for pain management. Numerous recent case reports have indicated its use in the management of acute postoperative pain following total knee arthroplasty. The patients showed an improvement in pain scores from baseline and faster achievement of postoperative milestones.

Nerve stimulation has been found to be effective for treating a variety of chronic pain states. Though, its use for acute pain is not much documented. Previous data from case reports suggest that the ultrasound-guided placement of electrodes and targeted electrical stimulation of specific peripheral nerves may have a role in the management of acute postoperative pain in total knee arthroplasty.