ArticlePlastic and reconstructive surgery. Global open2026
Peripheral Nerve Stimulation Reduces Opioid Use and Facilitates Early Ambulation Following Fibular Flap Harvest: A Retrospective Study.
Article in Plastic and reconstructive surgery. Global open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
Background: Fibular free flap (FFF) reconstruction is the gold standard for mandibular and maxillary defects, but donor-site pain remains challenging. Multimodal analgesia (MMA) relies on opioids, which risk dependence, systemic side effects, and delayed recovery. Regional nerve blocks reduce pain but have inconsistent efficacy owing to variable drug metabolism, potential effects on flap perfusion, and motor blockade. Temporary percutaneous peripheral nerve stimulation (TPNS) is a promising alternative that selectively modulates sensory pathways while preserving motor function. Methods: This retrospective, single-center study evaluated 26 patients who underwent FFF reconstruction between July 2021 and November 2025, divided into 2 cohorts: MMA alone and MMA with peroneal nerve TPNS. The primary outcome was opioid consumption, expressed as oral morphine equivalents. Secondary outcomes were postoperative pain scores, time to independent ambulation, and length of stay. Results: The TPNS group had significantly lower pain scores on postoperative days 2-5 ( Conclusions: TPNS may be a safe, opioid-sparing adjunct that promotes earlier mobilization after FFF harvest. Further study is needed to justify prospective, multicenter trials validating efficacy, cost-effectiveness, and broader applicability in head and neck reconstructive surgery.
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