Clinical trial NCT05635383: REBOUND PAIN AFTER PERIPHERAL NERVE BLOCKS
Official title: Investigation of the Frequency and Causes of Rebound Pain Phenomenon After Peripheral Nerve Blocks
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain
Block
Keywords: REBOUND PAIN
PERIPHERAL NERVE BLOCKS
analgesia
Lead sponsor: Diskapi Yildirim Beyazit Education and Research Hospital
Sponsor class: OTHER_GOV
First posted: 2022-12-02
Enrollment: 386
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients aged \>18 years who underwent orthopedic surgery with the peripheral nerve block will be included in the study.

Brief summary: In recent years, the use of regional anesthesia techniques as part of multimodal analgesia strategies to maximize pain control in patients has reduced opioid requirements and promoted early mobility and rehabilitation in the perioperative period. Regional anesthesia has benefits, mainly peripheral nerve blocks (PNB), muscle relaxation, and postoperative analgesia, thus allowing for control of postoperative pain and early discharge from the hospital. In addition, using PNB techniques provides:

Hemodynamic stability. Reduced need for a post-anesthetic care unit (PACU). Reduced unplanned hospitalization for pain control. Less airway management. Reduced incidence of opioid-related adverse events. Greater patient satisfaction

The main feature of rebound pain is that it is severe pain, within 8-24 hours after PNB. It usually remains severe for 2-6 hours, but the subsequent pain trajectory is consistent with the recovery process expected at surgical intervention. Therefore, rebound pain is temporary and different from persistent post-surgical pain (PPSP).

Rebound pain often occurs at night. However, this is probably related to the 8 to 12-hour duration of most single-injection PNBs and the completion of most elective surgeries during daylight hours.

Detailed description: This study aims to reveal the rebound pain profile, determine the risk factors, and contribute to developing strategies that can prevent rebound pain.

Eligibility criteria: Inclusion Criteria:

* Patients aged \>18 years who underwent orthopedic surgery with the peripheral nerve block

Exclusion Criteria:

* Patients who did not want to participate in the study
* dementia
* severe psychiatric or cognitive dysfunction
* coagulopathy
* neuropathic disorder
* local anesthetic allergy
* serious heart-lung disease
* chronic opioid use

Primary outcomes:
measure: incidence of rebound pain
timeFrame: perioperative period
Secondary outcomes:
measure: rebound pain risk factors
timeFrame: perioperative period
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: University of Medical Science, Yıldırım Beyazıt Training and Research Hospital
city: Ankara
country: Turkey
facility: Diskapi Yildirim Beyazit Education and Research Hospital
Study officials:
References:
citation: Williams BA, Bottegal MT, Kentor ML, Irrgang JJ, Williams JP. Rebound pain scores as a function of femoral nerve block duration after anterior cruciate ligament reconstruction: retrospective analysis of a prospective, randomized clinical trial. Reg Anesth Pain Med. 2007 May-Jun;32(3):186-92. doi: 10.1016/j.rapm.2006.10.011.
citation: Gramke HF, de Rijke JM, van Kleef M, Kessels AG, Peters ML, Sommer M, Marcus MA. Predictive factors of postoperative pain after day-case surgery. Clin J Pain. 2009 Jul-Aug;25(6):455-60. doi: 10.1097/AJP.0b013e31819a6e34.
citation: Lavand'homme P. Rebound pain after regional anesthesia in the ambulatory patient. Curr Opin Anaesthesiol. 2018 Dec;31(6):679-684. doi: 10.1097/ACO.0000000000000651.