Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Die Folgen des Klimwandels haben einen direkten Einfluss auf die Primärversorgung in Deutschland: Hitzeschutz insbesondere bei älteren Patienten, die Zunahme von Infektionen und die Verlängerung der Allergiesesaison spielen medizinisch eine bedeutsame Rolle. Aber auch in der Prävention und der Aufklärung der Patienten kommt den Hausärztinnen und -ärzten eine besondere Rolle zu. Direkt aus der Praxis berichtet im Live-Webinar am 13. Mai von 18 bis 19 Uhr unser Experte Dr. med. Robin Maitra.
Erweiterte Suche
Anmelden
nach oben
Current Pain and Headache Reports
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

Einloggen, um Zugang zu erhalten

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.
Lavand’homme P. Rebound pain after anesthesia in the ambulatory patient. Curr Opin Anesth. 2018;31:679–684.
2.
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.
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.
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.
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.
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.
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.
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.
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.
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.
• 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.
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.
• 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.
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.
Munoz-Levya F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef
16.
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.
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.
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.
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.
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.
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.
Bruhn J. Pain rebound in day surgery: how can we avoid it? Reg Anesth Pain Med. 2019;44:A8–10.
23.
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.
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.
Kunkle B, Kothandaraman V, Goodloe J, et al. Orthopaedic application of cryotherapy JBJS Reviews. 2021;9:1–20.
26.
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.
Munoz-Leyva F, Cubillos J, Chin KJ. Managing rebound pain after regional anesthesia. Korean J Anesth. 2020;73:372–83.CrossRef
28.
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.
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.
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.
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.
Knight JB, Schott NJ, Kentor ML, et al. Neurotoxicity of common peripheral nerve adjuvants. Curr Opin Anaesth. 2015;28:598–604.CrossRef
33.
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.
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.
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.
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

Weitere Artikel der Ausgabe 9/2023

Current Pain and Headache Reports 9/2023 Zur Ausgabe

Hot Topics in Pain and Headache (N Rosen, Section Editor)

Multi-agent Systems and Cancer Pain Management

Neuropathic Pain (A Abd-Elsayed, Section Editor)

Complex Regional Pain Syndrome: Evidence-Based Advances in Concepts and Treatments

Episodic Migraine (S Parikh, Section Editor)

A Brief Review of Gepants

Neuropathic Pain (A Abd-Elsayed, Section Editor)

Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives

Acute Pain Medicine (R Urman, Section Editor)

The Acute Perioperative Pain Service: Impact, Organization, and Future Directions

Neuropathic Pain (A Abd-Elsayed, Section Editor)

A Brief Review on the Novel Therapies for Painful Diabetic Neuropathy

Neu im Fachgebiet AINS

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Häufigste Gründe für Brustschmerzen bei Kindern

06.05.2024 Pädiatrische Diagnostik Nachrichten

Akute Brustschmerzen sind ein Alarmsymptom par exellence, schließlich sind manche Auslöser lebensbedrohlich. Auch Kinder klagen oft über Schmerzen in der Brust. Ein Studienteam ist den Ursachen nachgegangen.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren
Bildnachweise