{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T21:55:13Z","timestamp":1781387713250,"version":"3.54.1"},"reference-count":27,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005595","name":"University California","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100005595","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,6,10]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Following outpatient surgery, it is often difficult to provide adequate analgesia while concurrently minimizing opioid requirements. Ultrasound-guided percutaneous peripheral nerve stimulation has been proposed as an analgesic, but requires physician-level skills, advanced equipment, up to an hour to administer, and is frequently cost prohibitive. In contrast, percutaneous auricular neuromodulation may be placed by nursing staff in a few minutes without additional equipment, theoretically provides analgesia for nearly any anatomic location, lacks systemic side effects, and has no significant risks. We now present a case report to demonstrate proof of concept for the off-label use of an auricular neuromodulation device\u2014originally developed to treat symptoms associated with opioid withdrawal\u2014to instead provide analgesia following outpatient surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>Following moderately painful ambulatory orthopedic and breast surgery, seven patients had an auricular neuromodulation device (NSS-2 Bridge, Masimo, Irvine, California, USA) affixed within the recovery room in approximately 5\u2009min and discharged home. Average resting and dynamic pain scores measured on the 0\u201310 Numeric Rating Scale were a median of 1 over the first 2\u2009days, subsequently falling to 0. Five patients avoided opioid use entirely, while the remaining two each consumed 5\u2009mg of oxycodone during the first 1\u20132 postoperative days. After 5\u2009days, the devices were removed at home and discarded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These cases demonstrate that ambulatory percutaneous auricular neuromodulation is feasible and may be an effective analgesic and decreasing or even negating opioid requirements following outpatient surgery. Considering the lack of systemic side effects, serious adverse events, and misuse\/dependence\/diversion potential, further study with a randomized, controlled trial appears warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2022-103777","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T12:35:23Z","timestamp":1655469323000},"page":"581-585","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Percutaneous auricular nerve stimulation (neuromodulation) for the treatment of pain following outpatient surgery: a proof-of-concept case series"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-3273","authenticated-orcid":false,"given":"Brian M","family":"Ilfeld","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of California San Diego, La Jolla, California, 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