Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Rebound pain following peripheral nerve block anaesthesia in acute ankle fracture surgery: An exploratory pilot study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. External validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU)

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Inadequate emergence after non-cardiac surgery-A prospective observational study in 1000 patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Lower vs higher transfusion threshold in septic shock patients of different ages: A study protocol

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Performance of SAPS II according to ICU length of stay: A Danish nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Effects of simulated sample sizes on mortality estimates-Protocol for a study in 3 randomised ICU trials

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Research output: Contribution to journalComment/debateResearchpeer-review

  2. A randomised clinical trial of take-home laparoscopic training

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Peripheral nerve blocks (PNB) are increasingly used for anaesthesia and postoperative pain control in acute orthopaedic limb surgery but rebound pain upon cessation of PNBs may challenge the benefits on the pain profile. We aimed to explore the pain profile following acute ankle fracture surgery under PNB anaesthesia and investigate if rebound pain could pose a clinical problem.

METHODS: Exploratory, observational study of adults scheduled for acute primary internal fixation of an ankle fracture under ultrasound-guided popliteal sciatic and saphenous ropivacaine block anaesthesia. Postoperatively, patients regularly registered pain scores while receiving a fixed analgesics regimen and patient controlled morphine on-demand. We analysed morphine consumption and depicted the detailed pain profiles as graphs allowing for visual analysis of pain courses, including rebound pain. Secondly, we compared the area under the curve and peak pain between relevant age-subgroups.

RESULTS: We included 21 patients aged 20-83. Depicted pain profiles reveal that PNB supplied effective and long lasting postoperative pain control, but cessation of the PNB led to intense rises in pain scores with six out of nine 20-60-year-olds reaching severe pain levels. The rebound was less pronounced in patients >60 years old, but nearly all reached moderate pain levels. Morphine consumption rates were high during the rebound.

CONCLUSIONS: This study thoroughly analyses the post-PNB pain profile and suggests rebound pain is a clinically relevant and problematic issue with the potential to outweigh the PNB benefits, especially for younger patients. The conclusions are tentative, and a randomised study is pending.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Volume63
Issue number3
Pages (from-to)396-402
Number of pages7
ISSN0001-5172
DOIs
Publication statusPublished - Mar 2019

ID: 56704644