Rebound Pain
Conditions
Brief summary
The rebound pain after nerve block could interfere with patient's recovery and rehabilitation. It is not known how local anesthetic concentrations affect rebound pain. The aim of this study is evaluation of the effect of local anesthetic concentration on rebound pain after interscalene block for shoulder surgery.
Detailed description
Shoulder surgery is related to more than moderate pain after surgery. Interscalene nerve block could reduce the postoperative pain effectively. When the effect of nerve block ends, however, rebound pain could appear. The rebound pain could interfere with patient's recovery and rehabilitation. The mechanism of rebound pain is not well known. One of possible mechanism is that the pain stimulus that was blocked suddenly comes out, and it is perceived as more severe pain. The strength of the block may vary depending on the concentration of the local anesthetic. Therefore, the concentration of local anesthetics could affect rebound pain. The aim of this study is evaluation of the effect of local anesthetic concentration on rebound pain after interscalene block for shoulder surgery.
Interventions
OTHERReduced concentration of local anesthetic (ropivacaine)
Reduced concentration of ropivacaine We usually use 0.5% ropivacaine in our facility. The intervention group used 0.15% ropivacaine 15 ml
OTHERUsual concentration of local anesthetic (ropivacaine)
0.5% ropivacaine 15ml
Sponsors
Ajou University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
Only investigator who prepared the local anesthetics knows the group. Nerve block performer and outcome assessor are applied masking.
Intervention model description
Randomized controlled trial One group received interscalene block with 0.15% of ropivacaine One group received interscalene block with 0.5% of ropivacaine
Eligibility
Sex/Gender
ALL
Age
19 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Elective shoulder surgery under general anesthesia and interscalene block for postoperative pain
Exclusion criteria
* Contraindication of interscalene block: pulmonary disease, lung resection history, brachial nerve injury * Diabetic neuropathy * Adverse drug reaction history to ropivacaine, fentanyl * Impaired coagulation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rebound pain score | 48 hours after surgery | It is calculated by subtracting the visual analogue scale (VAS) of pain at the last time when the nerve block was effective from the highest VAS for 12 hours from the time when the nerve block effect disappeared. VAS of pain: 0=no pain \ 10=very severe pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total postoperative fentanyl dose | 48 hours after surgery | Total dose of fentanyl injected (mcg) through patient controlled analgesia (PCA) for 48 hours after surgery |
| fentanyl bolus injection time | 48 hours after surgery | Number of bolus injection times using patient controlled analgesia (PCA) |
| Subjective satisfaction | 48 hours after surgery | Patient's subjective satisfaction 48 hours after surgery Use visual analogue scale (0=very unsatisfied, 10= very satisfied) |
Countries
South Korea
Contacts
Primary ContactIn Kyong Yi, MD
Outcome results
None listed