As a regional nerve block wears off there is risk of a surgical patient experiencing severe pain.
Definition: sudden increase in pain in a patient with pain previously well-controlled.
Mechanism: resolution of the nerve block
Risk factors for rebound pain:
(1) surgical procedure involving bone
(2) female sex
(3) pediatric patient
(4) brachial plexus block
(5) analgesic with short duration of action
Mitigation steps:
(1) continuous infusion of anesthetic into nerve catheter (rather than single-shot peripheral nerve block)
(2) anesthetic formulated for prolonged action
(3) starting oral or parenteral analgesics before nerve block wears off
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Specialty: Anesthesiology, Surgery, general
