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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