Rebound Pain Scores as a Function of Femoral Nerve Block Duration After Anterior Cruciate Ligament Reconstruction: Retrospective Analysis of a Prospective, Randomized Clinical Trial

Williams, Brian A.; Bottegal, Matthew T.; Kentor, Michael L.; Irrgang, James J.; Williams, John P.

doi:10.1016/j.rapm.2006.10.011

Cited by 83 publications

(119 citation statements)

References 17 publications

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“…In contrast to the findings of patients who received general anesthesia, patients who received a brachial plexus blockade which when coupled with increased fentanyl or morphine use in the PACU (increased use compared with the brachial plexus blockade group), these patients were provided with a steady linear downward trend in postoperative pain. This is consistent with other studies comparing single-injection nerve blocks and general anesthesia for other orthopaedic surgeries [10,23]. This finding is important for the understanding, management, and counseling of patients regarding perioperative pain expectations and control.…”

Section: Discussionsupporting

confidence: 91%

“…The reason for reversal in pain levels may be related to the phenomenon of ''rebound pain,'' a poorly described entity that is commonly defined as a dramatic increase in pain once singleinjection regional anesthesia has dissipated [18,20]. Different regions of the body have been shown to experience rebound pain after regional anesthesia at different times, modulated by increasing the length of analgesic efficacy [23]. In a retrospective study of patients receiving a femoral nerve block with a perineural catheter for ACL reconstruction, rebound pain was a common phenomenon as seen by increases in VAS scores once the analgesic stopped working, but was attenuated by longer-duration analgesia at a minimum of 33 hours [23].…”

Section: Discussionmentioning

confidence: 99%

“…Different regions of the body have been shown to experience rebound pain after regional anesthesia at different times, modulated by increasing the length of analgesic efficacy [23]. In a retrospective study of patients receiving a femoral nerve block with a perineural catheter for ACL reconstruction, rebound pain was a common phenomenon as seen by increases in VAS scores once the analgesic stopped working, but was attenuated by longer-duration analgesia at a minimum of 33 hours [23]. In a prospective study of patients undergoing shoulder arthroscopy, rebound pain occurred 1 to 2 days postoperatively after interscalene block [20].…”

Section: Discussionmentioning

confidence: 99%

“…Once pain was under control and patients were comfortable, they were discharged home and able to regulate their pain with oral analgesics. The brachial plexus blockade group left the PACU earlier because they were comfortable during the immediate postoperative period [7,23].…”

Section: Discussionmentioning

confidence: 99%

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Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Galos

Taormina

Crespo

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Distal radius fractures are very common injuries and surgical treatment for them can be painful. Achieving early pain control may help improve patient satisfaction and improve functional outcomes. Little is known about which anesthesia technique (general anesthesia versus brachial plexus blockade) is most beneficial for pain control after distal radius fixation which could significantly affect patients' postoperative course and experience. Questions/Purposes We asked: (1) Did patients receiving general anesthesia or brachial plexus blockade have worse pain scores at 2, 12, and 24 hours after surgery? (2) Was there a difference in operative suite time between patients who had general anesthesia or brachial plexus blockade, and was there a difference in recovery room time? (3) Did patients receiving general anesthesia or brachial plexus blockade have higher narcotic use after surgery? (4) Do patients receiving general anesthesia or brachial plexus blockade have higher functional assessment scores after distal radius fracture repair at 6 weeks and 12 weeks after surgery? Methods A randomized controlled study was performed between February, 2013 and April, 2014 at a multicenter metropolitan tertiary-care referral center. Patients who presented with acute closed distal radius fractures (Orthopaedic Trauma Association 23A-C) were potentially eligible for inclusion. During the study period, 40 patients with closed, displaced, and unstable distal radius fractures were identified as meeting inclusion criteria and offered enrollment and randomization. Three patients (7.5%), all with concomitant injuries, declined to participate at the time of randomization as did one additional patient (2.5%) who chose not to participate, leaving a final sample of 36 participants. There were no dropouts after randomization, and analyses were performed according to an intention-totreat model. Patients were randomly assigned to one of two groups, general anesthesia or brachial plexus blockade, and among the 36 patients included, 18 were randomized to each group. Medications administered in the postanesthesia care unit were recorded. Patients were discharged receiving oxycodone and acetaminophen 5/325 mg for pain control, and VAS forms were provided. Patients were called at predetermined intervals postoperatively (2 hours, 4 hours, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours) to gather pain scores, using the VAS, and to document the doses of analgesics consumed. In addition, patients had regular followups at 2 weeks, 6 weeks, and 12 weeks. Pain scores were again recorded using the VAS at these visits.Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Galos

Taormina

Crespo

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…Authors suggest that this may be due to rebound pain [92,93]. Ultimately, TAP blocks may reduce or delay opioid use during the first 2-24 h postoperatively, after which patients may require greater opioid consumption to compensate for the transient hyperalgesia experienced during block regression [91].…”

Section: Transversus Abdominis Plane Blockmentioning

confidence: 99%

Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

Moaveni

Cohn

Zahid

et al. 2015

Curr Anesthesiol Rep

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The care of obstetric patients has become challenging due to the changing demographics of the pregnant population. Women with chronic diseases and congenital heart disease live to child-bearing age due to medical and surgical advances. Older and less healthy women become pregnant due to advances in reproductive technologies. Therefore, obstetric anesthesiologists have an increasingly important role in the peripartum period. In this article, we review the role of obstetric anesthesiologists in the antepartum, intrapartum, and postpartum periods. The need for multidisciplinary care of high-risk parturients is discussed, including the role of anesthesiologists in the National Maternal Health Initiative to improve maternal morbidity and mortality.

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Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures

Lee

Ramamurti

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Open reduction and internal fixation (ORIF) are commonly utilized for the repair of distal radius fractures (DRF). While general anesthesia (GA) is typically administered for ORIF, recent studies have also demonstrated promising results with the usage of regional anesthesia (RA) in the surgical treatment of distal radius fractures. This study will compare complication rates between the use of RA versus GA for ORIF of DRFs. Methods A multi-institutional surgical registry was utilized to identify patients who had undergone ORIF for DRFs from 2005 to 2018—these patients were stratified into GA and RA cohorts. Patients were matched utilizing coarsened-exact-matching (CEM) to compare postoperative outcomes and rates of 30-day complications were compared between the two cohorts. Results Upon CEM-matching, 1191 patients receiving RA were matched to 9250 patients who had received GA, with a multivariate imbalance measure (L1) statistic of < 0.001. In the matched-cohort analysis, no significant differences were observed in rates of any complication (all p ≥ 0.083). On multivariate regression analyses, RA was not associated with increased risk for any complication ( p = 0.445), minor complications ( p = 0.093), major complications ( p = 0.758), unplanned reoperations ( p = 0.355), unplanned readmissions ( p = 0.799), or mortality ( p = 0.579). Conclusion With similar safety profiles, RA is a safe and reasonable alternative to GA when managing DRFs surgically. RA may be the preferred anesthetic technique for ORIF of DRFs in patients at high risk with GA, such as those with reactions to GA in the past or with significant cardiopulmonary risk factors. Supplementary Information The online version contains supplementary material available at 10.1007/s00068-021-01704-1.

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Rebound Pain Scores as a Function of Femoral Nerve Block Duration After Anterior Cruciate Ligament Reconstruction: Retrospective Analysis of a Prospective, Randomized Clinical Trial

Cited by 83 publications

References 17 publications

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures

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