IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i18p3257-d264303.html
   My bibliography  Save this article

Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review

Author

Listed:
  • Olufunke Dada

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

  • Alicia Gonzalez Zacarias

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

  • Corinna Ongaigui

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

  • Marco Echeverria-Villalobos

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

  • Michael Kushelev

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

  • Sergio D. Bergese

    (Department of Anesthesiology, Stony Brook University, Stony Brook, New York, NY 11794, USA)

  • Kenneth Moran

    (Department of Anesthesiology, The Ohio State University Wexner Medical Center, 520 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA)

Abstract

Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. A search of relevant keywords was performed using PubMed, EMBASE, and Web of Science. Twenty-eight articles (n = 28) were included in our review. Perioperative considerations for peripheral nerve blocks and other alternatives used for postoperative pain management in patients undergoing orthopedic surgeries were discussed. Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.

Suggested Citation

  • Olufunke Dada & Alicia Gonzalez Zacarias & Corinna Ongaigui & Marco Echeverria-Villalobos & Michael Kushelev & Sergio D. Bergese & Kenneth Moran, 2019. "Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review," IJERPH, MDPI, vol. 16(18), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3257-:d:264303
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/18/3257/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/18/3257/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Meghan A Kirksey & Stephen C Haskins & Jennifer Cheng & Spencer S Liu, 2015. "Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-23, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hye Won Shin & Bum Jun Ju & Yoo Kyung Jang & Hae Seun You & Hyun Kang & Ji Yong Park, 2017. "Effect of tramadol as an adjuvant to local anesthetics for brachial plexus block: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-19, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3257-:d:264303. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.