Prophylactic interventions to prevent rebound pain after peripheral nerve block in adults: a systematic review and network meta-analysis of randomised controlled trials.
Narinder Pal Singh, Jeetinder Kaur Makkar, Chelsea Zhang et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated pharmacological strategies to prevent rebound pain after peripheral nerve blocks in 2130 adults. Intravenous dexamethasone was found to significantly reduce the incidence of rebound pain, with a surface under the cumulative ranking curve of 0.91, indicating it is 'definitely superior' to control. Other interventions like perineural dexamethasone and dexmedetomidine also showed benefits.
Key findings
- Intravenous dexamethasone had a surface under the cumulative ranking curve of 0.91 for reducing rebound pain incidence.
- Perineural dexamethasone and dexmedetomidine delayed rebound pain and prolonged time to first rescue analgesia.
- Pre-emptive opioids were probably inferior to control in preventing rebound pain.
Why it matters
Understanding effective strategies to prevent rebound pain is crucial for optimizing postoperative recovery and enhancing the benefits of regional anesthesia. This knowledge can guide clinicians in selecting appropriate prophylactic interventions.