Clinical trial NCT06966011: Rebound Pain After Peripheral Nerve Blocks in Total Knee Arthroplasty
Official title: Pain Management After Total Knee Arthroplasty: Incidence and Outcomes of Rebound Pain
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Total Knee Arthroplasty
Postoperative Pain
Rebound Pain
Peripheral Nerve Block
Pain Management
Lead sponsor: Konya City Hospital
Sponsor class: OTHER
First posted: 2025-05-11
Enrollment: 300
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population consists of adult patients aged 18 to 70 years who are scheduled for elective unilateral total knee arthroplasty under spinal anesthesia at a tertiary care hospital. All participants will receive peripheral nerve blocks as part of a standardized multimodal analgesia protocol. Patients must be physically and cognitively able to provide consent and complete a postoperative pain diary. Those with contraindications to regional anesthesia, allergies to local anesthetics, or significant comorbidities (ASA IV and above) will be excluded.

Brief summary: This prospective observational study aims to determine the incidence and clinical impact of rebound pain after peripheral nerve blocks in patients undergoing total knee arthroplasty. Rebound pain is defined as a sudden, severe pain (NRS ≥7) emerging after block resolution. Primary outcome is the incidence of rebound pain; secondary outcomes include pain severity, rescue analgesia use, nausea, vomiting, sleep quality, and patient satisfaction.


Eligibility criteria: Inclusion Criteria:

* Age between 18 and 70 years
* ASA physical status I to III
* Scheduled for elective unilateral total knee arthroplasty under spinal anesthesia
* Peripheral nerve block (PNB) planned as part of multimodal analgesia
* Ability to understand and provide written informed consent
* Willingness and ability to complete the postoperative pain diary

Exclusion Criteria:

* Known allergy or hypersensitivity to local anesthetics
* Contraindication to regional anesthesia
* ASA physical status IV or higher
* Neurological or psychiatric disorders interfering with study participation or pain reporting
* Use of anticoagulants or presence of coagulopathy
* Use of medications that may alter pain perception or rebound pain response
* Local infection at the block site
* Emergency surgeries
* Inability or unwillingness to complete the postoperative pain diary or follow-up

Primary outcomes:
measure: Incidence of Rebound Pain After Peripheral Nerve Block
timeFrame: Within 48 hours after surgery
Secondary outcomes:
measure: Sleep Quality
timeFrame: From 1 day before surgery to postoperative day 7
measure: Patient Satisfaction with Pain Management
timeFrame: Postoperative day 7 (via telephone follow-up)
measure: Total Rescue Analgesic Consumption
timeFrame: Within 48 hours after surgery
measure: Time to First Rescue Analgesia
timeFrame: Within 48 hours after surgery
Other outcomes:
Locations:
city: Konya
country: Turkey
facility: Konya City Hospital
Study officials:
References: