We would like to thank our colleagues for their thoughtful letter regarding the use of percutaneous peripheral nerve stimulation to treat postoperative pain. We agree that combining a local anesthetic–based peripheral nerve block with percutaneous peripheral nerve stimulation will most likely prove the optimal management after painful surgical procedures, although we hesitate to describe it as “novel” given this combination was reported in multiple publications previously.3–6  Several feasibility studies found that the acute pain from orthopedic procedures such as rotator cuff repair frequently required the addition of local anesthetic–based nerve block to percutaneous peripheral nerve stimulation in the recovery room.3–6  Therefore, in a recently completed randomized, double-masked, sham-controlled trial (n = 66), we administered a single-injection ropivacaine peripheral nerve block after ultrasound-guided percutaneous lead insertion in all participants (NCT03481725). While the ropivacaine peripheral...

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