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Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)
Background and Aims Rebound pain after regional anaesthesia (RA) is often an under-recognised yet debilitating condition occurring after resolution of the nerve block. Rebound pain disrupts functional recovery, postoperative discharge and patient satisfaction. This retrospective audit aimed to investigate the incidence and factors associated with rebound pain in patients undergoing surgery.
Methods Data was retrospectively collected from patients who underwent surgery in Khoo Teck Puat Hospital, Singapore, over a period of 1 year, and had received single-shot peripheral nerve block or spinal anaesthesia. Patient demographics, surgery types, Visual Analogue Scale scores, upon resolution of RA, were collated.
Results A total of 1177 patients were studied. Incidence of severe rebound pain was low, 0.8% at rest and 4.5% on movement. Incidence of moderate rebound pain was 6.4% at rest and 19.1% on movement. Age ≤ 55, Indian ethnicity, surgical type and surgical site were associated with increased rebound pain at rest (p<0.05). Female gender, Indian ethnicity and surgical site were associated with increased rebound pain on movement (p<0.05). Moderate-severe rebound pain at rest and movement were common in tibia surgeries (66%) , shoulder surgeries (53 – 73%) and below- knee amputations (20 – 60%).
Conclusions Younger patients (< 55 years old), Indian race, and operations such as shoulder, tibia and below-knee amputations have higher rebound pain scores. Understanding the risk factors can help to identify patients who will benefit from measures such as preemptive multimodal analgesia before block recession and continuous RA techniques.
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