Rebound pain after interscalene brachial plexus block for shoulder surgery: a randomized clinical trial of the effect of different multimodal analgesia regimens

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dc.authoridEt, Tayfun/0000-0002-0111-3360
dc.contributor.authorEt, Tayfun
dc.contributor.authorBasaran, Betul
dc.contributor.authorBilge, Aysegul
dc.contributor.authorYarimoglu, Rafet
dc.contributor.authorKorkusuz, Muhammet
dc.contributor.authorTueluece, Ibrahim
dc.date.accessioned2024-01-22T12:22:28Z
dc.date.available2024-01-22T12:22:28Z
dc.date.issued2023
dc.departmentKMÜen_US
dc.description.abstractBACKGROUND: Rebound pain is characterized by sudden, significant acute postoperative pain occurring after the resolution of inter-scalene block (ISB); it affects the quality of recovery postoperatively. Dexamethasone increases ISB resolution time and decreases opioid consumption and the incidence of rebound pain.OBJECTIVE: Evaluate whether multimodal analgesia including intravenous dexamethasone administration with preoperative ISB reduces the incidence of rebound pain.DESIGN: Prospective, randomized, controlled trialSETTING: Tertiary university hospitalSAMPLE SIZE: 60 patientsPATIENTS AND METHODS: Patients who underwent shoulder surgery under general anesthesia were assigned randomly to two different multimodal analgesia protocols. Thirty patients received 5 mg IV dexamethasone with non-steroid, paracetamol, and ISB with 15 mL 0.5% bupivacaine, while the control patients received the same regimen and ISB with 15 mL 0.5% bupivacaine without dexamethasone. Postoperative opioids were given to any patient on demand.MAIN OUTCOMES MEASURES: Effect of IV dexamethasone on pain score and incidence of rebound pain after ISB resolution and postoperative opioid consumption at 0-48 hours, numerical pain rating scale (NPRS) scores, sleep scale scores, and quality of recovery-15 scores (QoR-15).RESULTS: The incidence of rebound pain was lower in the dexamethasone group than in the control group (73.3% and 30%, respectively, P=.001). NPRS scores after ISB resolution were lower in the dexamethasone group (5 ([4-7]), 8 ([5.75-8]), P<.001, respectively). Those who received IV dexamethasone had less sleep disturbances (P<.001) and higher QoR-15 on day 1 (P<.001) and day 7 (P=.020) postoperatively.CONCLUSIONS: IV dexamethasone added to the ISB block resulted in a lower incidence of rebound pain. In addition, better results were obtained in postoperative sleep quality and QoR-15.LIMITATIONS: Single-center studyCONFLICT OF INTEREST: None.en_US
dc.identifier.doi10.5144/0256-4947.2023.339
dc.identifier.endpage347en_US
dc.identifier.issn0256-4947
dc.identifier.issn1319-9226
dc.identifier.issue6en_US
dc.identifier.pmid38071444en_US
dc.identifier.pmid38071444
dc.identifier.scopus2-s2.0-85179639528
dc.identifier.scopusqualityQ2
dc.identifier.startpage339en_US
dc.identifier.urihttps://doi.org/10.5144/0256-4947.2023.339
dc.identifier.urihttps://hdl.handle.net/11492/7998
dc.identifier.volume43en_US
dc.identifier.wosWOS:001125167000004
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Sceince
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherK Faisal Spec Hosp Res Centreen_US
dc.relation.ispartofAnnals of Saudi Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmzkmusnmz
dc.titleRebound pain after interscalene brachial plexus block for shoulder surgery: a randomized clinical trial of the effect of different multimodal analgesia regimensen_US
dc.typeArticle

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