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Erschienen in: Current Pain and Headache Reports 9/2023

30.06.2023 | Acute Pain Medicine (R Urman, Section Editor)

Postoperative Rebound Pain: Our Current Understanding About the Role of Regional Anesthesia and Multimodal Approaches in Prevention and Treatment

verfasst von: Elizabeth Luebbert, Meg A. Rosenblatt

Erschienen in: Current Pain and Headache Reports | Ausgabe 9/2023

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Abstract

Purpose of Review

Rebound pain (RP) is a common occurrence after peripheral nerve block placement, especially when blocks are used for orthopedic surgery. This literature review focuses on the incidence and risk factors for RP as well as preventative and treatment strategies.

Recent Findings

The addition of adjuvants to a block, when appropriate, and starting patients on oral analgesics prior to sensory resolution are reasonable approaches. Using continuous nerve block techniques can provide extended analgesia through the immediate postoperative phase when pain is the most intense.

Summary

Peripheral nerve blocks (PNBs) are associated with RP, a frequent phenomenon that must be recognized and addressed to prevent short-term pain and patient dissatisfaction, as well as long-term complications and avoidable hospital resource utilization. Knowledge about the advantages and limitations of PNBs allows the anesthesiologists to anticipate, intervene, and hopefully mitigate or avoid the phenomenon of RP.
Literatur
1.
Zurück zum Zitat Lavand’homme P. Rebound pain after anesthesia in the ambulatory patient. Curr Opin Anesth. 2018;31:679–684. Lavand’homme P. Rebound pain after anesthesia in the ambulatory patient. Curr Opin Anesth. 2018;31:679–684.
2.
Zurück zum Zitat Gerbershagen HJ, Pogatzki-Zahn E, Aduckathil S, et al. Procedure-specific risk factor analysis for the development of severe postoperative pain. Anesth. 2014;120:1237–45.CrossRef Gerbershagen HJ, Pogatzki-Zahn E, Aduckathil S, et al. Procedure-specific risk factor analysis for the development of severe postoperative pain. Anesth. 2014;120:1237–45.CrossRef
3.
Zurück zum Zitat de Oliveira RM, Tenorio SB, Tanaka PP, Precoma D. Control of pain through epidural block and incidence of cardiac dysrhythmias in postoperative period of thoracic and major abdominal surgical procedures: a comparative study. Rev Bras Aneseth. 2012;62:10–8.CrossRef de Oliveira RM, Tenorio SB, Tanaka PP, Precoma D. Control of pain through epidural block and incidence of cardiac dysrhythmias in postoperative period of thoracic and major abdominal surgical procedures: a comparative study. Rev Bras Aneseth. 2012;62:10–8.CrossRef
4.
Zurück zum Zitat Shea RA, Brooks JA, Dayhoff NE. Keck J Pain intensity and postoperative pulmonary complications among the elderly after abdominal surgery. Heart Lung. 2002;31:440–9.CrossRefPubMed Shea RA, Brooks JA, Dayhoff NE. Keck J Pain intensity and postoperative pulmonary complications among the elderly after abdominal surgery. Heart Lung. 2002;31:440–9.CrossRefPubMed
5.
Zurück zum Zitat Fletcher D, Stamer UM, Pogatzki-Zahn E, et al. Chronic postsurgical pain in Europe: an observational study. Eur J Anaesth. 2015;32:725–34.CrossRef Fletcher D, Stamer UM, Pogatzki-Zahn E, et al. Chronic postsurgical pain in Europe: an observational study. Eur J Anaesth. 2015;32:725–34.CrossRef
6.
Zurück zum Zitat McGrath B, Elgendy H, Chung F, et al. Thirty percentage of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients. Can J Anaesth. 2004;51:886–91.CrossRefPubMed McGrath B, Elgendy H, Chung F, et al. Thirty percentage of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients. Can J Anaesth. 2004;51:886–91.CrossRefPubMed
7.
Zurück zum Zitat Joshi G, Ghandi K, Shah N, et al. Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities. J Clin Anesth. 2016;35:524–9.CrossRef Joshi G, Ghandi K, Shah N, et al. Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities. J Clin Anesth. 2016;35:524–9.CrossRef
8.
Zurück zum Zitat Egol KA, Soojian MG, Walsh M. Regional anesthesia improves outcome after distal radius fracture fixation over general anesthesia. J Orthop Trauma. 2012;26:545–9.CrossRefPubMed Egol KA, Soojian MG, Walsh M. Regional anesthesia improves outcome after distal radius fracture fixation over general anesthesia. J Orthop Trauma. 2012;26:545–9.CrossRefPubMed
9.
Zurück zum Zitat Sunderland S, Yarnhold CH, Head SJ, et al. Regional versus general anesthesia and the incidence of unplanned health care resource utilization for postoperative pain after wrist fracture surgery: results from retrospective quality improvement project. Reg Anesth Pain Med. 2016;41:22–7.CrossRefPubMed Sunderland S, Yarnhold CH, Head SJ, et al. Regional versus general anesthesia and the incidence of unplanned health care resource utilization for postoperative pain after wrist fracture surgery: results from retrospective quality improvement project. Reg Anesth Pain Med. 2016;41:22–7.CrossRefPubMed
10.
Zurück zum Zitat Dada O, Gonzalez Zacarias A, Ongaigui C, et al. Does rebound pain after peripheral nerve block for orthopedic surgery impact postoperative analgesia and opioid consumption? A narrative review. Int J Environ Res Public Health. 2019;16:3257.CrossRefPubMedPubMedCentral Dada O, Gonzalez Zacarias A, Ongaigui C, et al. Does rebound pain after peripheral nerve block for orthopedic surgery impact postoperative analgesia and opioid consumption? A narrative review. Int J Environ Res Public Health. 2019;16:3257.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat • Hade A, Okano S, Pelecanos A, et al. Factors associated with low levels of patient satisfaction following peripheral nerve block. Sage J. 2021;49:125–32. Source 11 (from 3/2021) detailed the reality of RP in contributing to patient dissatisfaction scores and how this phenomenon cannot be ignored and must be addressed. • Hade A, Okano S, Pelecanos A, et al. Factors associated with low levels of patient satisfaction following peripheral nerve block. Sage J. 2021;49:125–32. Source 11 (from 3/2021) detailed the reality of RP in contributing to patient dissatisfaction scores and how this phenomenon cannot be ignored and must be addressed.
12.
Zurück zum Zitat Henningsen MJ, Sort R, Møller AM, et al. Peripheral nerve block in ankle fracture surgery: a qualitative study of patients’ experiences. Anaesth. 2018;73:49–58.CrossRef Henningsen MJ, Sort R, Møller AM, et al. Peripheral nerve block in ankle fracture surgery: a qualitative study of patients’ experiences. Anaesth. 2018;73:49–58.CrossRef
13.
Zurück zum Zitat • Barry G, Bailey JG, Sardinha J, et al. Factors associated with rebound pain after peripheral nerve block for ambulatory surgery. Br J Anaesth. 2021;126:862–71. Source 13 (from 2021) laid the groundwork for exploring the factors associated with RP and how RP can be prevented. • Barry G, Bailey JG, Sardinha J, et al. Factors associated with rebound pain after peripheral nerve block for ambulatory surgery. Br J Anaesth. 2021;126:862–71. Source 13 (from 2021) laid the groundwork for exploring the factors associated with RP and how RP can be prevented.
14.
Zurück zum Zitat Touil N, Pavlopoulou A, Barbier O, et al. Evaluation of intraoperative ketamine on the prevention of severe rebound pain upon cessation of peripheral nerve block: a prospective randomized, double-blind, placebo controlled study. Br J Anaesth. 2022;128:734–41.CrossRefPubMed Touil N, Pavlopoulou A, Barbier O, et al. Evaluation of intraoperative ketamine on the prevention of severe rebound pain upon cessation of peripheral nerve block: a prospective randomized, double-blind, placebo controlled study. Br J Anaesth. 2022;128:734–41.CrossRefPubMed
15.
Zurück zum Zitat Munoz-Levya F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef Munoz-Levya F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef
16.
Zurück zum Zitat Nobre LV, Cunha GP, Branco de Sousa PCC, et al. Peripheral nerve block and rebound pain: literature review. Rev Bras Anest. 2019;69:587–93. Nobre LV, Cunha GP, Branco de Sousa PCC, et al. Peripheral nerve block and rebound pain: literature review. Rev Bras Anest. 2019;69:587–93.
17.
Zurück zum Zitat Kolarczyk LM, Williams BA. Transient heat hyperalgesia during resolution of ropivacaine sciatic nerve block in the rat. Reg Anesth Pain Med. 2011;36:220–4.CrossRefPubMedPubMedCentral Kolarczyk LM, Williams BA. Transient heat hyperalgesia during resolution of ropivacaine sciatic nerve block in the rat. Reg Anesth Pain Med. 2011;36:220–4.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Morita S, Oizumi N, Suenaga N, et al. Dexamethasone added to levobupivacaine prolongs the duration of interscalene brachial plexus block and decreases rebound pain after arthroscopic rotator cuff repair. J Shoudler Elbow Surg. 2020;29:1751–7.CrossRef Morita S, Oizumi N, Suenaga N, et al. Dexamethasone added to levobupivacaine prolongs the duration of interscalene brachial plexus block and decreases rebound pain after arthroscopic rotator cuff repair. J Shoudler Elbow Surg. 2020;29:1751–7.CrossRef
19.
Zurück zum Zitat Jen TTH, Ke JXC, Wing KJ, et al. Development of internal validation of a multivariable risk prediction model for severe rebound pain after foot and ankle surgery involving single-shot popliteal sciatic nerve block. Br J Anaesth. 2022;129:127–35.CrossRefPubMed Jen TTH, Ke JXC, Wing KJ, et al. Development of internal validation of a multivariable risk prediction model for severe rebound pain after foot and ankle surgery involving single-shot popliteal sciatic nerve block. Br J Anaesth. 2022;129:127–35.CrossRefPubMed
20.
Zurück zum Zitat Abdallah FW, Halpern SH, Aoyama K, Brull R. Will the real benefits of single shot interscalene block please stand up? A systemic revie wand meta-analysis. Anesth Analg. 2015;120:1114–29.CrossRefPubMed Abdallah FW, Halpern SH, Aoyama K, Brull R. Will the real benefits of single shot interscalene block please stand up? A systemic revie wand meta-analysis. Anesth Analg. 2015;120:1114–29.CrossRefPubMed
21.
Zurück zum Zitat Komen H, Brunt LM, Deych E, et al. Intraoperative methadone in same-day ambulatory surgery: a randomized, double-blinded, dose-finding pilot study. Anesth Analg. 2019;128:802–10.CrossRefPubMedPubMedCentral Komen H, Brunt LM, Deych E, et al. Intraoperative methadone in same-day ambulatory surgery: a randomized, double-blinded, dose-finding pilot study. Anesth Analg. 2019;128:802–10.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Bruhn J. Pain rebound in day surgery: how can we avoid it? Reg Anesth Pain Med. 2019;44:A8–10. Bruhn J. Pain rebound in day surgery: how can we avoid it? Reg Anesth Pain Med. 2019;44:A8–10.
23.
Zurück zum Zitat Zhu T, Gao Y, Xu X, et al. Effect of ketamine added to ropivacaine in nerve block for postoperative pain management in patients undergoing anterior cruciate ligament reconstruction: a randomized trial. Clin Ther. 2020;42:882–91.CrossRefPubMed Zhu T, Gao Y, Xu X, et al. Effect of ketamine added to ropivacaine in nerve block for postoperative pain management in patients undergoing anterior cruciate ligament reconstruction: a randomized trial. Clin Ther. 2020;42:882–91.CrossRefPubMed
24.
Zurück zum Zitat Zangrilli J, Szukics P, Austin L, et al. Perioperative pain management in ambulatory and inpatient shoulder surgery. JBJS Reviews. 2021;9:1–10.CrossRef Zangrilli J, Szukics P, Austin L, et al. Perioperative pain management in ambulatory and inpatient shoulder surgery. JBJS Reviews. 2021;9:1–10.CrossRef
25.
Zurück zum Zitat Kunkle B, Kothandaraman V, Goodloe J, et al. Orthopaedic application of cryotherapy JBJS Reviews. 2021;9:1–20. Kunkle B, Kothandaraman V, Goodloe J, et al. Orthopaedic application of cryotherapy JBJS Reviews. 2021;9:1–20.
26.
Zurück zum Zitat Dawson S, Loewenstein SS, rebound pain after peripheral nerve block for ambulatory extremity surgery is an underappreciated problem. Comment on Br J Anaesth. 126:862–71. Br J Anaesth. 2021(126):e204–205. Dawson S, Loewenstein SS, rebound pain after peripheral nerve block for ambulatory extremity surgery is an underappreciated problem. Comment on Br J Anaesth. 126:862–71. Br J Anaesth. 2021(126):e204–205.
27.
Zurück zum Zitat Munoz-Leyva F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef Munoz-Leyva F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef
28.
Zurück zum Zitat Williams BA, Bottegal MT, Kentor ML, et al. 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;32:186–92.PubMedPubMedCentral Williams BA, Bottegal MT, Kentor ML, et al. 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;32:186–92.PubMedPubMedCentral
29.
Zurück zum Zitat Kim JH, Koh HJ, Dong KK, et al. Interscalene brachial plexus bolus block versus patient-controlled interscalene indwelling catheter analgesia for the first 48 hours after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2018;27:1243–50.CrossRefPubMed Kim JH, Koh HJ, Dong KK, et al. Interscalene brachial plexus bolus block versus patient-controlled interscalene indwelling catheter analgesia for the first 48 hours after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2018;27:1243–50.CrossRefPubMed
30.
Zurück zum Zitat Ganta A, Ding D, Fisher N, et al. Continuous infraclavicular brachial plexus block versus single-shot nerve block for distal radius surgery: a prospective randomized control trial. Orthop Trauma. 2018;32:22–6. Ganta A, Ding D, Fisher N, et al. Continuous infraclavicular brachial plexus block versus single-shot nerve block for distal radius surgery: a prospective randomized control trial. Orthop Trauma. 2018;32:22–6.
31.
Zurück zum Zitat Ding DY, Manoli A III, Galos D. Continuous popliteal sciatic nerve block versus single injection nerve block for ankle fracture surgery: a prospective randomized comparative trial. J Orthop Trauma. 2015;29:392–8.CrossRef Ding DY, Manoli A III, Galos D. Continuous popliteal sciatic nerve block versus single injection nerve block for ankle fracture surgery: a prospective randomized comparative trial. J Orthop Trauma. 2015;29:392–8.CrossRef
32.
Zurück zum Zitat Knight JB, Schott NJ, Kentor ML, et al. Neurotoxicity of common peripheral nerve adjuvants. Curr Opin Anaesth. 2015;28:598–604.CrossRef Knight JB, Schott NJ, Kentor ML, et al. Neurotoxicity of common peripheral nerve adjuvants. Curr Opin Anaesth. 2015;28:598–604.CrossRef
33.
Zurück zum Zitat Williams BA, Ibinson JW, Mangione MP. Research priorities regarding multimodal peripheral nerve blocks for postoperative analgesia and anesthesia based on hospital quality data extracted from over 1,300 cases (2011–2014). Pain Med. 2015;16:7–12.CrossRefPubMed Williams BA, Ibinson JW, Mangione MP. Research priorities regarding multimodal peripheral nerve blocks for postoperative analgesia and anesthesia based on hospital quality data extracted from over 1,300 cases (2011–2014). Pain Med. 2015;16:7–12.CrossRefPubMed
34.
Zurück zum Zitat An K, Elkassabany NM, Liu J. Dexamethasone as adjuvant to bupivacaine prolongs the duration of thermal antinociception and prevents bupivacaine-induced rebound hyperalgesia via regional mechanism in a mouse sciatic nerve block model. PLoS ONE. 2015;10:e0123459.CrossRefPubMedPubMedCentral An K, Elkassabany NM, Liu J. Dexamethasone as adjuvant to bupivacaine prolongs the duration of thermal antinociception and prevents bupivacaine-induced rebound hyperalgesia via regional mechanism in a mouse sciatic nerve block model. PLoS ONE. 2015;10:e0123459.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Woo JH, Lee HJ, Oh HW, et al. Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial. Reg Anesth Pain Med. 2021;46:965–70.CrossRefPubMed Woo JH, Lee HJ, Oh HW, et al. Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial. Reg Anesth Pain Med. 2021;46:965–70.CrossRefPubMed
36.
Zurück zum Zitat El-Boghdadly K, Brull R, Sehmbi H, et al. Perineural dexmedetomidine is more effective than clonidine when added to local anesthetic for supraclavicular brachial plexus block: a systemic revie wand meta-analysis. Anesth Analg. 2017;124:2008–20.CrossRefPubMed El-Boghdadly K, Brull R, Sehmbi H, et al. Perineural dexmedetomidine is more effective than clonidine when added to local anesthetic for supraclavicular brachial plexus block: a systemic revie wand meta-analysis. Anesth Analg. 2017;124:2008–20.CrossRefPubMed
Metadaten
Titel
Postoperative Rebound Pain: Our Current Understanding About the Role of Regional Anesthesia and Multimodal Approaches in Prevention and Treatment
verfasst von
Elizabeth Luebbert
Meg A. Rosenblatt
Publikationsdatum
30.06.2023
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 9/2023
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-023-01136-z

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