Department of Anesthesiology, Perioperative, and Pain Medicine, Mount Sinai Morningside and West Hospitals, New York, NY, USA.
Curr Pain Headache Rep. 2023 Sep;27(9):449-454. doi: 10.1007/s11916-023-01136-z. Epub 2023 Jun 30.
Rebound pain (RP) is a common occurrence after peripheral nerve block placement, especially when blocks are used for orthopedic surgery. This literature review focuses on the incidence and risk factors for RP as well as preventative and treatment strategies.
The addition of adjuvants to a block, when appropriate, and starting patients on oral analgesics prior to sensory resolution are reasonable approaches. Using continuous nerve block techniques can provide extended analgesia through the immediate postoperative phase when pain is the most intense. Peripheral nerve blocks (PNBs) are associated with RP, a frequent phenomenon that must be recognized and addressed to prevent short-term pain and patient dissatisfaction, as well as long-term complications and avoidable hospital resource utilization. Knowledge about the advantages and limitations of PNBs allows the anesthesiologists to anticipate, intervene, and hopefully mitigate or avoid the phenomenon of RP.
外周神经阻滞(P nerve block,PNB)后出现反跳痛(rebound pain,RP)较为常见,尤其是在骨科手术中使用阻滞时。本文重点关注 RP 的发生率和危险因素,以及预防和治疗策略。
在适当的情况下,向阻滞中添加佐剂,并在感觉恢复前开始给予患者口服镇痛药,这是合理的方法。使用连续神经阻滞技术可通过术后即刻疼痛最剧烈的阶段提供延长的镇痛。外周神经阻滞(PNB)与 RP 相关,RP 是一种常见现象,必须加以识别和处理,以防止短期疼痛和患者不满,以及长期并发症和可避免的医院资源利用。了解 PNB 的优缺点使麻醉医生能够预测、干预,并希望减轻或避免 RP 现象。