Risk Factors and Prevention of Severe Pain Upon Cessation of a Peripheral Nerve Block

Overview

Risk factors and Prevention of severe Pain upon cessation of a peripheral nerve block. A prospective randomized study in ambulatory patients undergoing upper limb bone surgery under single shot axillary plexus block.

Pain in the course of upper limb bone surgery is a major source of discomfort for patients during postoperative time. Severe post-operative pain is a risk factor for chronic pain. Use of a well-known molecule, regularly used in anesthesiology. Prospective double-blind study on 120 patients. Pain rebound upon awakening of the axillary plexus during upper limb bone surgery is a frequent phenomenon in post-operative follow-up of patients. The anti-hyperalgesic properties of ketamine could be a benefit against this effect. No studies have combined intravenous ketamine with localoregional anesthesia to reduce pain upon its release. This may improve patients' post-operative comfort. The patients will be randomized in 2 groups and allocated to receive (slow intravenous injection) either 0.3 mg/kg intravenous ketamine diluted into 10mL saline or 10 mL 0.9% saline after the realization of PNB, before tourniquet set up and beginning of surgery.

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