REBOUND PAIN AFTER PERIPHERAL NERVE BLOCKS

Pain Clinical Trial

Official title:

Investigation of the Frequency and Causes of Rebound Pain Phenomenon After Peripheral Nerve Blocks

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05635383
• Other study ID #: 9.5.2022 137/01
• Status: Completed
• Start date: August 1, 2022
• Est. completion date: March 12, 2024

Study information

• Verified date: March 2024
• Source: Diskapi Yildirim Beyazit Education and Research Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Description:

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

Recruitment information / eligibility

• Status: Completed
• Enrollment: 386
• Est. completion date: March 12, 2024
• Est. primary completion date: January 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 99 Years

Eligibility

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

Related Conditions & MeSH terms

• Block
• Pain

Intervention

Other:
• PERIPHERAL NERVE BLOCK
Observation of rebound pain after peripheral nerve block application

Locations

Country	Name	City	State
Turkey	Diskapi Yildirim Beyazit Education and Research Hospital	Ankara
Turkey	University of Medical Science, Yildirim Beyazit Training and Research Hospital	Ankara

Sponsors (1)

Lead Sponsor	Collaborator
Diskapi Yildirim Beyazit Education and Research Hospital

Country where clinical trial is conducted

Turkey, 

References & Publications (3)

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. — View 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. — View 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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	incidence of rebound pain	Rebound pain-defined as transient acute postoperative pain within 12-24hrs that ensues following resolution of sensory blocked.	perioperative period
Secondary	rebound pain risk factors	such as age, gender, and presence of preoperative pain.	perioperative period