Evidence supports the use of complementary techniques to reduce pain and opioids use after bariatric surgery. A study conducted in rats demonstrated that NSS-2 BRIDGE device (NBD) modulates pain via the stimulation of nucleus of the auricular branch of the cranial nerves at the level of the brainstem and more specifically at the level of the limbic system. We investigated the role that auricular nerve field stimulation using the NBD in bariatric surgery.
A total of 20 patients divided in 2 groups according to patient's acceptance to have the device or not: NBD group (n=10) and a control group (n=10). The NBD was placed following LRYGB in the recovery room. The effectiveness of NBD was assessed comparing the relative use of opioid consumption (oral morphine equivalent = OME), pain (0 = no pain to 10= worst possible pain), and device tolerability (1-10), 8-10 considered excellent. Data was analyzed using unpaired t-test and presented as mean +- Standard Deviation (SD). Alpha was set up at 0.1.
Compared to the control group, the use of NBD was associated with a 74 % reduction in OME (32.75 mg vs 15.11 mg; p<0.1) and a 41.5% reduction in pain (5.0 vs 3.28; p<0.1). The tolerability of NBD was reported to be excellent.
This report suggests that NBD may represent an interesting alternative to control perioperative pain and limit the use of opioids following bariatric surgery. However, these findings need to be confirmed by a placebo control randomized study.