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Background <p>This prospective observational study aimed to explore the frequency and risk factors of rebound pain (RP) in patients treated with multimodal analgesia and intravenous dexamethasone following a peripheral nerve block (PNB).</p> Material and methods <p>All patients who received preoperative PNB were given a&#xa0;standard multimodal analgesia regimen and intravenous dexamethasone. Motor and sensory block durations, RP severity and frequency were measured for the first 24 h post-PNB using a&#xa0;semistructured questionnaire. The RP was identified as acute postoperative pain within the first 12–24 h after sensory blockade resolution. The severity of RP was determined through the rebound pain score. Contributing risk factors to the development of RP were investigated.</p> Results <p>After the PNB had worn off RP developed in 27.7%. The following were identified as independent risk factors for RP: patient age, with an adjusted odds ratio (AOR) of&#xa0;2.3 and a&#xa0;95% confidence interval (CI) of 1.4–3.9, the use of bupivacaine in combination with lidocaine or prilocaine (AOR: 2.1, 95% CI 1.2–3.8), preoperative pain (AOR: 2.8, 95% CI 1.3–5.6), bone surgery (AOR: 1.8, 95% CI 1.0–3.0) and the duration of the surgery (AOR: 2.8, 95% CI 1.5–5.1).</p> Conclusion <p>An exact identification of risk factors for RP can aid in creating preventative strategies that target changeable elements. A comprehensive understanding of this occurrence by PNB practitioners can lead to more effective use of PNB, decreased RP instances and improved outcome optimization.</p>

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Frequency of rebound pain and related factors in a multimodal regimen including systemic dexamethasone and dexmedetomidine

  • 期刊论文

  • 发表日期：

    2025年2月24日

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  • Funda Atar,
  • Fatma Özkan Sipahioğlu,
  • Filiz Karaca Akaslan,
  • Eda Macit Aydın,
  • Evginar Sezer,
  • Derya Özkan

摘要

Background

This prospective observational study aimed to explore the frequency and risk factors of rebound pain (RP) in patients treated with multimodal analgesia and intravenous dexamethasone following a peripheral nerve block (PNB).

Material and methods

All patients who received preoperative PNB were given a standard multimodal analgesia regimen and intravenous dexamethasone. Motor and sensory block durations, RP severity and frequency were measured for the first 24 h post-PNB using a semistructured questionnaire. The RP was identified as acute postoperative pain within the first 12–24 h after sensory blockade resolution. The severity of RP was determined through the rebound pain score. Contributing risk factors to the development of RP were investigated.

Results

After the PNB had worn off RP developed in 27.7%. The following were identified as independent risk factors for RP: patient age, with an adjusted odds ratio (AOR) of 2.3 and a 95% confidence interval (CI) of 1.4–3.9, the use of bupivacaine in combination with lidocaine or prilocaine (AOR: 2.1, 95% CI 1.2–3.8), preoperative pain (AOR: 2.8, 95% CI 1.3–5.6), bone surgery (AOR: 1.8, 95% CI 1.0–3.0) and the duration of the surgery (AOR: 2.8, 95% CI 1.5–5.1).

Conclusion

An exact identification of risk factors for RP can aid in creating preventative strategies that target changeable elements. A comprehensive understanding of this occurrence by PNB practitioners can lead to more effective use of PNB, decreased RP instances and improved outcome optimization.