Factors associated with rebound pain after peripheral nerve block for ambulatory surgery
| Autor: | Garrett Barry, Paul Brousseau, Vishal Uppal, Joel Sardinha, Jonathan G. Bailey |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cohort Studies Young Adult Patient satisfaction medicine Humans Peripheral Nerves Aged Pain Measurement Retrospective Studies Aged 80 and over Pain Postoperative business.industry Incidence (epidemiology) Retrospective cohort study Perioperative Odds ratio Ambulatory Surgical Procedure Middle Aged Confidence interval Surgery Anesthesiology and Pain Medicine Ambulatory Surgical Procedures Ambulatory Female business Autonomic Nerve Block Follow-Up Studies |
| Zdroj: | British journal of anaesthesia. 126(4) |
| ISSN: | 1471-6771 |
| Popis: | Background Rebound pain is a common, yet under-recognised acute increase in pain severity after a peripheral nerve block (PNB) has receded, typically manifesting within 24 h after the block was performed. This retrospective cohort study investigated the incidence and factors associated with rebound pain in patients who received a PNB for ambulatory surgery. Methods Ambulatory surgery patients who received a preoperative PNB between March 2017 and February 2019 were included. Rebound pain was defined as the transition from well-controlled pain (numerical rating scale [NRS] ≤3) while the block is working to severe pain (NRS ≥7) within 24 h of block performance. Patient, surgical, and anaesthetic factors were analysed for association with rebound pain by univariate, multivariable, and machine learning methods. Results Four hundred and eighty-two (49.6%) of 972 included patients experienced rebound pain as per the definition. Multivariable analysis showed that the factors independently associated with rebound pain were younger age (odds ratio [OR] 0.98; 95% confidence interval [CI] 0.97–0.99), female gender (OR 1.52 [1.15–2.02]), surgery involving bone (OR 1.82 [1.38–2.40]), and absence of perioperative i.v. dexamethasone (OR 1.78 [1.12–2.83]). Despite a high incidence of rebound pain, there were high rates of patient satisfaction (83.2%) and return to daily activities (96.5%). Conclusions Rebound pain occurred in half of the patients and showed independent associations with age, female gender, bone surgery, and absence of intraoperative use of i.v. dexamethasone. Until further research is available, clinicians should continue to use preventative strategies, especially for patients at higher risk of experiencing rebound pain. |
| Databáze: | OpenAIRE |
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