Frequency of rebound pain and related factors in a multimodal regimen including systemic dexamethasone and dexmedetomidine Häufigkeit von Rebound-Schmerzen und damit verbundene Faktoren bei einer multimodalen Therapie mit systemischem Dexamethason und Dexmedetomidin
Anaesthesiologie, cilt.74, sa.3, ss.148-155, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 74 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s00101-025-01502-z
- Dergi Adı: Anaesthesiologie
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.148-155
- Anahtar Kelimeler: Regional anesthesia, Peripheral nerve block, Postoperative pain, Pain management, Orthopedic surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.