Rebound Pain After Peripheral Nerve Blocks in Total Knee Arthroplasty

Konya City Hospital300 enrolled

Overview

This prospective observational study aims to determine the incidence and clinical impact of rebound pain after peripheral nerve blocks in patients undergoing total knee arthroplasty. Rebound pain is defined as a sudden, severe pain (NRS ≥7) emerging after block resolution. Primary outcome is the incidence of rebound pain; secondary outcomes include pain severity, rescue analgesia use, nausea, vomiting, sleep quality, and patient satisfaction.

Study Type

OBSERVATIONAL

Enrollment

300

Conditions

Total Knee Arthroplasty Postoperative Pain Rebound Pain Peripheral Nerve Block Pain Management

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18 and 70 years * ASA physical status I to III * Scheduled for elective unilateral total knee arthroplasty under spinal anesthesia * Peripheral nerve block (PNB) planned as part of multimodal analgesia * Ability to understand and provide written informed consent * Willingness and ability to complete the postoperative pain diary Exclusion Criteria: * Known allergy or hypersensitivity to local anesthetics * Contraindication to regional anesthesia * ASA physical status IV or higher * Neurological or psychiatric disorders interfering with study participation or pain reporting * Use of anticoagulants or presence of coagulopathy * Use of medications that may alter pain perception or rebound pain response * Local infection at the block site * Emergency surgeries * Inability or unwillingness to complete the postoperative pain diary or follow-up

Outcomes

Primary Outcomes

Incidence of Rebound Pain After Peripheral Nerve Block

Rebound pain is defined as a sudden, severe increase in pain occurring after the resolution of peripheral nerve block, typically within 12-24 hours postoperatively. Pain intensity will be assessed using the Numeric Rating Scale (NRS; 0 = no pain, 10 = worst imaginable pain). A score of NRS ≥7 will be considered as severe pain. Patients will record pain scores in a pain diary, and incidence will be calculated as the proportion of patients meeting the rebound pain criteria.

Time frame: Within 48 hours after surgery

Secondary Outcomes

Sleep Quality

Sleep quality will be assessed using a 6-item sleep questionnaire (scored 1-6, where 1 = best and 6 = worst sleep quality), covering the night before surgery and the first 7 nights postoperatively.

Time frame: From 1 day before surgery to postoperative day 7

Patient Satisfaction with Pain Management

Patients will rate their satisfaction with postoperative pain control on a 5-point Likert scale (1 = not at all satisfied, 5 = completely satisfied).

Time frame: Postoperative day 7 (via telephone follow-up)

Total Rescue Analgesic Consumption

The total dose of rescue opioid analgesics administered within the first 48 hours postoperatively will be recorded in milligrams.

Time frame: Within 48 hours after surgery

Time to First Rescue Analgesia

Time elapsed from the end of surgery to the first administration of rescue analgesia will be recorded.

Time frame: Within 48 hours after surgery

Rebound Pain After Peripheral Nerve Blocks in Total Knee Arthroplasty

Overview

Conditions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts