Auricular field nerve stimulation using the NSS-2 BRIDGE® device as an alternative to opioids following kidney donor surgery

Jacques E. Chelly; Amy L. Monroe; Raymond M. Planinsic; Amit Tevar; Brittany E. Norton

doi:10.1515/jcim-2021-0208

Article

Auricular field nerve stimulation using the NSS-2 BRIDGE^® device as an alternative to opioids following kidney donor surgery

Jacques E. Chelly , Amy L. Monroe , Raymond M. Planinsic , Amit Tevar and Brittany E. Norton

Published/Copyright: November 1, 2021

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From the journal Journal of Complementary and Integrative Medicine Volume 19 Issue 2

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

Corresponding author: Jacques E. Chelly, MD, PhD, MBA, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, University of Pittsburgh Medical Center, Aiken Medical Building, Posner Pain Center 532 South Aiken Ave, Pittsburgh, PA, USA, Phone: +412 623 6904, E-mail: chelje@anes.upmc.edu

Prior presentation: The abstract portion of this manuscript was shared as a poster at the American Society of Anesthesiologists Annual Meeting on October 2–5, 2020.
Research funding: Department of Anesthesiology and Perioperative Medicine, 3550 Terrace Street, A-1305 Scaife Hall, Pittsburgh, Pennsylvania, 15213.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. Authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Jacques E. Chelly, M.D. PhD, MBA: Development of the protocol, IRB submission, conduct of the study, data analysis, statistical analysis and development the manuscript and the revised version. Amy Monroe, MPH, MBA: Development of the protocol, IRB submission, conduct of the study, data analysis, statistical analysis and development the manuscript and the revised version. Raymond M. Planinsic, MD, FASA: Development of the protocol, conduct of the study, and review of the manuscript and the revised version. Amit Tevar, MD: Conduct of the study, review of the manuscript and the revised version. Brittany E. Norton: Preparation of the revised version.
Competing interests: Amy Monroe, Jacques Chelly, Raymond Planinsic, Amit Tevar, and Brittany Norton declare that they have no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: This study was approved by the University of Pittsburgh’s Human Research Protection Office’s Institutional Review Board.
Data availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2021-05-19

Accepted: 2021-10-11

Published Online: 2021-11-01

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Articles in the same Issue

https://doi.org/10.1515/jcim-2021-0208

Keywords for this article

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