REBOUND PAIN AFTER PERIPHERAL NERVE BLOCKS

In recent years, the use of regional anesthesia techniques as part of multimodal analgesia strategies to maximize pain control in patients has reduced opioid requirements and promoted early mobility and rehabilitation in the perioperative period. Regional anesthesia has benefits, mainly peripheral nerve blocks (PNB), muscle relaxation, and postoperative analgesia, thus allowing for control of postoperative pain and early discharge from the hospital. In addition, using PNB techniques provides:Hemodynamic stability. Reduced need for a post-anesthetic care unit (PACU). Reduced unplanned hospitalization for pain control. Less airway management. Reduced incidence of opioid-related adverse events. Greater patient satisfactionThe main features of rebound pain are; It is a burning type of severe mechanical-surgical pain unresponsive to intravenous opioid administration, occurring both at rest and in motion, caused by nociceptive inputs within 8-24 hours after PNB. It usually remains severe for 2-6 hours, but the subsequent pain trajectory is consistent with the recovery process expected at surgical intervention. Therefore, rebound pain is temporary and different from persistent post-surgical pain (PPSP). The rebound pain score (RPS), defined by Williams and colleagues, is a standard measure of rebound pain severity and is calculated by subtracting the lowest pain score scored in the first 12 hours before the effect of PNB wears off and the highest pain score during the first 12 hours after PNB resolution. However, a recommended cut-off value for determining the incidence of rebound pain needs to be added. Rebound pain often occurs at night. However, this is probably related to the 8 to 12-hour duration of most single-injection PNBs and the completion of most elective surgeries during daylight hours.This study aims to reveal the rebound pain profile, determine the risk factors, and contribute to developing strategies that can prevent rebound pain.

Inclusion Criteria:Patients aged >18 years who underwent elective non-cardiac surgery with the peripheral nerve blockExclusion Criteria:Patients who did not want to participate in the study, had dementia, severe psychiatric or cognitive dysfunction, ongoing drug/alcohol abuse, known local anesthetic allergy, other injuries requiring opioid analgesics, and pregnant patients