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Background and Aims Rebound pain describes an increase in pain sensation after a peripheral nerve block has receded. Theories suggests rebound pain may be due to inadequate pre-emptive systemic analgesia whilst the block is receding, or hyperalgesia after local anaesthetic. Our centre introduced standardised discharge analgesia regimes for upper limb surgery under regional anaesthesia. We sought to identify whether adequate long-acting analgesia and patient education affected our patients experience with day case trapeziectomy under regional anaesthesia.

Methods Following local department audit/QI committee approval patients undergoing elective trapeziectomy, over a year long period and meeting inclusion criteria were discharged with standardised TTOs including 3 doses of a prolonged release opioid and a patient information leaflet. They were followed up by a qualitative telephone questionnaire at 4-6 weeks. These results were compared with a retrospective interview with patients having been identified as having had a trapeziectomy in the 12 months preceding the introduction of standardised TTOs. Results were compared using the Chi squared significance test.

Results A total of 44 patients met inclusion criteria, 24 pre and 20 post standardisation. Pain scores (p=0.21), and satisfaction (p=0.42) showed no significant difference. Sleep quality trended towards significance (p= 0.067, but significantly fewer patients required to seek further medical help for pain management post discharge (25% vs 0%, p<0.05).

Conclusions The introduction of long-acting analgesia and patient information leaflets did not significantly alter the post operative pain scores, patient sleep quality or patient satisfaction. However, significantly fewer patients required to see their healthcare provider for further post discharge analgesia.