Clinical trial NCT05357105: Rebound Pain Following Surgery With Regional Anesthesia Block
Official title: Rebound Pain Following Surgery With Regional Anesthesia Block: A Prospective Cohort Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Regional Anesthesia Morbidity
Pain, Postoperative
Keywords: Rebound Pain
Nerve Block
Lead sponsor: University of Alberta
Sponsor class: OTHER
First posted: 2022-05-02
Enrollment: 119
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients 18-75 years who are receiving peripheral nerve block as part for anesthesia/analgesia as part of standard perioperative care for surgery performed at University of Alberta Hospital.

Brief summary: For some kinds of surgery, Anesthesiologists provide nerve blocks (regional anesthesia) to reduce pain from surgery by injecting freezing medication around deep nerves with ultrasound. Nerve blocks help with pain control following surgery and reduce the amount of strong opioids needed but relatively little research has focused on the pain that occurs once the nerve block has worn off. This is called rebound or transition pain.

This research study will prospectively collect data including pain scores before, during and after nerve blocks are given for surgery. We will look at the type of nerve blocks and other analgesia medications used with the aim of quantifying rebound pain to better understand how to limit it's impact on quality postoperative pain control.


Eligibility criteria: Inclusion Criteria:

* Age 18-75 years
* Receiving peripheral nerve block as part for anesthesia/analgesia as part of standard perioperative care for surgery performed at University of Alberta Hospital during a 6 month period
* Elective and emergency surgery

Exclusion Criteria:

* Inability to consent to participate in the study (illiteracy, \<7th grade education)
* Contraindication/history of hypersensitivity to local anesthetics

Primary outcomes:
measure: Numerical Pain Scale
timeFrame: 2-3 times per patient over the course of a nerve block, up to 48 hours after the stop of the block (single shot or cessation of nerve catheter)
Secondary outcomes:
Other outcomes:
Locations:
city: Edmonton
country: Canada
facility: University of Alberta Hospital
state: Alberta
Study officials:
affiliation: University of Alberta Department of Anesthesiology and Pain Medicine
name: James Green, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Koepke EJ, Manning EL, Miller TE, Ganesh A, Williams DGA, Manning MW. The rising tide of opioid use and abuse: the role of the anesthesiologist. Perioper Med (Lond). 2018 Jul 3;7:16. doi: 10.1186/s13741-018-0097-4. eCollection 2018.
citation: Brummett CM, Waljee JF, Goesling J, Moser S, Lin P, Englesbe MJ, Bohnert ASB, Kheterpal S, Nallamothu BK. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg. 2017 Jun 21;152(6):e170504. doi: 10.1001/jamasurg.2017.0504. Epub 2017 Jun 21.
citation: Sunderland S, Yarnold CH, Head SJ, Osborn JA, Purssell A, Peel JK, Schwarz SK. Regional Versus General Anesthesia and the Incidence of Unplanned Health Care Resource Utilization for Postoperative Pain After Wrist Fracture Surgery: Results From a Retrospective Quality Improvement Project. Reg Anesth Pain Med. 2016 Jan-Feb;41(1):22-7. doi: 10.1097/AAP.0000000000000325.
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.
citation: Barry GS, Bailey JG, Sardinha J, Brousseau P, Uppal V. Factors associated with rebound pain after peripheral nerve block for ambulatory surgery. Br J Anaesth. 2021 Apr;126(4):862-871. doi: 10.1016/j.bja.2020.10.035. Epub 2020 Dec 31.