Incidence and risk factors associated with development of rebound pain after peripheral nerve block in trauma surgeries: an observational study

This single-centre prospective cohort study will be conducted at   Advanced Trauma Centre located at Post Graduate Institute of Medical education and research Chandigarh, India.

The preoperative assessment of pain at rest and pain during the previous 24 hrs at the operative site will be assessed using a numeric rating scale (NRS) from 0 to 10 (where 0.no pain and 10 worst possible pain) In the operating room, procedure will be performed by treating anaesthesiologist as per institute protocol with dexamethasone 4mg as additive to volume of drug given for block. Patients will be followed up for 24 hrs after surgery. Age, gender, BMI, baseline pain scores and ASA physical status will be included as patient factors. Surgical site and involvement of bone (e.g. debridement, fixation, amputation, tendon repair) will be included as surgical factors. Local anaesthetic type and dose, type of PNB, use of additive will be included as anaesthetic factors. Type of PNB will be grouped as brachial plexus block (axillary, supraclavicular, or infraclavicular block), interscalene block (ISB), sciatic nerve block (subgluteal and popliteal blocks), and distal PNBs (e.g. ankle and wrist blocks). Pain scores in the PACU and post-discharge use of acetaminophen and NSAIDS will be included as postoperative factors. Durations of motor block and sensory block will be calculated from block time to when the patients reported motor and sensory resolution of the block, respectively. We will exclude patients who received peripheral nerve blocks for analgesia with general anaesthesia.