{
  "abstract": "Background\n\nFibular 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\n\nThis 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\n\nThe TPNS group had significantly lower pain scores on postoperative days 2-5 (P < 0.05). Cumulative opioid use was clinically but not statistically lower (median oral morphine equivalents 11.25 versus 105 mg; P = 0.1), as was median time to independent ambulation (3.71 versus 4.76 d; P = 0.24).Conclusions\n\nTPNS 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.",
  "abstract_shown": true,
  "affiliations": [
    "From the Department of Oral and Maxillofacial Surgery, Naval Medical Center San Diego, San Diego, CA.",
    "Warfighter Performance Department, Naval Health Research Center San Diego, San Diego, CA.",
    "Military and Veterans Health Solutions, Leidos, Inc., San Diego, CA.",
    "Department of Anesthesiology and Pain Medicine, Naval Medical Center San Diego, San Diego, CA.",
    "Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA.",
    "Department of Plastic and Reconstructive Surgery, Naval Medical Center San Diego, San Diego, CA.",
    "Department of Plastic and Reconstructive Surgery, Missouri University Hospital, Columbia, MO."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kyu J Choi"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Alexander Ivan B Posis"
    },
    {
      "affs": [
        3
      ],
      "name": "Alane Costanzo"
    },
    {
      "affs": [
        3
      ],
      "name": "Anthony Scherschel"
    },
    {
      "affs": [
        4
      ],
      "name": "Jesse R Qualliotine"
    },
    {
      "affs": [
        5
      ],
      "name": "Yan T Ortiz-Pomales"
    },
    {
      "affs": [
        6
      ],
      "name": "Eamon O'Reilly"
    },
    {
      "affs": [
        0
      ],
      "name": "Daniel A Hammer"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b08jydyvtnvyd.bib",
  "cited_by": 0,
  "doi": "10.1097/gox.0000000000008167",
  "fulltext_url": "https://europepmc.org/articles/PMC13680925",
  "id": "b08jydyvtnvyd",
  "issns": [
    "2169-7574"
  ],
  "landing_url": "https://europepmc.org/article/MED/42903310",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7223058676",
  "pdf_url": "https://europepmc.org/articles/PMC13680925?pdf=render",
  "pmcid": "PMC13680925",
  "pmid": "42903310",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b08jydyvtnvyd.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42903310",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903310"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Peripheral Nerve Stimulation Reduces Opioid Use and Facilitates Early Ambulation Following Fibular Flap Harvest: A Retrospective Study.",
  "title_text": "Peripheral Nerve Stimulation Reduces Opioid Use and Facilitates Early Ambulation Following Fibular Flap Harvest: A Retrospective Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/b08jydyvtnvyd",
  "venue": "Plastic and reconstructive surgery. Global open",
  "versions": []
}