Peripheral nerve blocks help manage shoulder surgery pain but are short-acting, often causing rebound pain. Catheters extend relief but pose infection risks and require more resources. Long-acting liposomal bupivacaine has mixed results.

Peri-Auricular Nerve Stimulation (PANS) targets nerves like the auriculotemporal, glossopharyngeal, and occipital, modulating neurotransmitters for analgesia. Auricular stimulation, linked to acupuncture, reduces opioid use post-kidney donation. FDA-approved for opioid withdrawal, a recent study found it effective for postoperative pain after single-shot nerve blocks in ambulatory shoulder surgery. Patients reported low pain, minimal opioid use, and ease of home use.

This study evaluates PANS in primary rotator cuff repair, assessing pain, opioid use, and nausea against a historical control. Preliminary pilot results are available.