Managing rebound pain after regional anesthesia
Rebound pain after regional anesthesia can be defined as transient acute postoperative pain that ensues following resolution of sensory blockade, and is clinically significant, either with regard to the intensity of pain or the impact on psychological well-being, quality of recovery, and activities...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2020-10-01
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| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kja-20436.pdf |
| _version_ | 1828485405681385472 |
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| author | Felipe Muñoz-Leyva Javier Cubillos Ki Jinn Chin |
| author_facet | Felipe Muñoz-Leyva Javier Cubillos Ki Jinn Chin |
| author_sort | Felipe Muñoz-Leyva |
| collection | DOAJ |
| description | Rebound pain after regional anesthesia can be defined as transient acute postoperative pain that ensues following resolution of sensory blockade, and is clinically significant, either with regard to the intensity of pain or the impact on psychological well-being, quality of recovery, and activities of daily living. Current evidence suggests that it represents an unmasking of the expected nociceptive response in the absence of adequate systemic analgesia, rather than an exaggerated hyperalgesic phenomenon induced by local anesthetic neural blockade. In the majority of patients, it does not appear to significantly impact cumulative postoperative opioid consumption, quality of recovery, or patient satisfaction, and is not associated with longer-term sequelae such as persistent post-surgical pain. Nevertheless, it must be considered whenever regional anesthesia is incorporated into perioperative management. Strategies to mitigate the impact of rebound pain include routine prescribing of a systemic multimodal analgesic regimen, as well as patient education on appropriate expectations regarding block offset and expected surgical pain, and timely initiation of analgesic medication. Prolonging the duration of action of regional anesthesia with continuous catheter techniques or local anesthetic adjuncts may also help alleviate rebound pain, although further research is required to confirm this. |
| first_indexed | 2024-12-11T09:12:24Z |
| format | Article |
| id | doaj.art-6290725e2b9c4849a6a2525f65dcfec6 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-11T09:12:24Z |
| publishDate | 2020-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-6290725e2b9c4849a6a2525f65dcfec62022-12-22T01:13:27ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632020-10-0173537238310.4097/kja.204368680Managing rebound pain after regional anesthesiaFelipe Muñoz-Leyva0Javier Cubillos1Ki Jinn Chin2 Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Department of Anesthesia and Perioperative Medicine, University Hospital, London Health Sciences Center, Western University, London, ON, Canada Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaRebound pain after regional anesthesia can be defined as transient acute postoperative pain that ensues following resolution of sensory blockade, and is clinically significant, either with regard to the intensity of pain or the impact on psychological well-being, quality of recovery, and activities of daily living. Current evidence suggests that it represents an unmasking of the expected nociceptive response in the absence of adequate systemic analgesia, rather than an exaggerated hyperalgesic phenomenon induced by local anesthetic neural blockade. In the majority of patients, it does not appear to significantly impact cumulative postoperative opioid consumption, quality of recovery, or patient satisfaction, and is not associated with longer-term sequelae such as persistent post-surgical pain. Nevertheless, it must be considered whenever regional anesthesia is incorporated into perioperative management. Strategies to mitigate the impact of rebound pain include routine prescribing of a systemic multimodal analgesic regimen, as well as patient education on appropriate expectations regarding block offset and expected surgical pain, and timely initiation of analgesic medication. Prolonging the duration of action of regional anesthesia with continuous catheter techniques or local anesthetic adjuncts may also help alleviate rebound pain, although further research is required to confirm this.http://ekja.org/upload/pdf/kja-20436.pdfmultimodal analgesiaopioid consumptionpostoperative analgesiapostoperative painrebound painregional anesthesia |
| spellingShingle | Felipe Muñoz-Leyva Javier Cubillos Ki Jinn Chin Managing rebound pain after regional anesthesia Korean Journal of Anesthesiology multimodal analgesia opioid consumption postoperative analgesia postoperative pain rebound pain regional anesthesia |
| title | Managing rebound pain after regional anesthesia |
| title_full | Managing rebound pain after regional anesthesia |
| title_fullStr | Managing rebound pain after regional anesthesia |
| title_full_unstemmed | Managing rebound pain after regional anesthesia |
| title_short | Managing rebound pain after regional anesthesia |
| title_sort | managing rebound pain after regional anesthesia |
| topic | multimodal analgesia opioid consumption postoperative analgesia postoperative pain rebound pain regional anesthesia |
| url | http://ekja.org/upload/pdf/kja-20436.pdf |
| work_keys_str_mv | AT felipemunozleyva managingreboundpainafterregionalanesthesia AT javiercubillos managingreboundpainafterregionalanesthesia AT kijinnchin managingreboundpainafterregionalanesthesia |