Rebound Pain After Peripheral Nerve Blocks in Total Knee Arthroplasty

Pain Management After Total Knee Arthroplasty: Incidence and Outcomes of Rebound Pain

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT06966011

Enrollment

294

Registered

2025-05-11

Start date

2025-05-21

Completion date

2026-03-03

Last updated

2026-04-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pain Management, Peripheral Nerve Block, Postoperative Pain, Rebound Pain, Total Knee Arthroplasty

Brief summary

This prospective observational study aims to determine the incidence and clinical impact of rebound pain after peripheral nerve blocks in patients undergoing total knee arthroplasty. Rebound pain is defined as a sudden, severe pain (NRS ≥7) emerging after block resolution. Primary outcome is the incidence of rebound pain; secondary outcomes include pain severity, rescue analgesia use, nausea, vomiting, sleep quality, and patient satisfaction.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to 70 Years

Healthy volunteers

Inclusion criteria

* Age between 18 and 70 years * ASA physical status I to III * Scheduled for elective unilateral total knee arthroplasty under spinal anesthesia * Peripheral nerve block (PNB) planned as part of multimodal analgesia * Ability to understand and provide written informed consent * Willingness and ability to complete the postoperative pain diary

Exclusion criteria

* Known allergy or hypersensitivity to local anesthetics * Contraindication to regional anesthesia * ASA physical status IV or higher * Neurological or psychiatric disorders interfering with study participation or pain reporting * Use of anticoagulants or presence of coagulopathy * Use of medications that may alter pain perception or rebound pain response * Local infection at the block site * Emergency surgeries * Inability or unwillingness to complete the postoperative pain diary or follow-up

Design outcomes

Primary

Measure	Time frame	Description
Incidence of Rebound Pain After Peripheral Nerve Block	Within 48 hours after surgery	Rebound pain is defined as a sudden, severe increase in pain occurring after the resolution of peripheral nerve block, typically within 12-24 hours postoperatively. Pain intensity will be assessed using the Numeric Rating Scale (NRS; 0 = no pain, 10 = worst imaginable pain). A score of NRS ≥7 will be considered as severe pain. Patients will record pain scores in a pain diary, and incidence will be calculated as the proportion of patients meeting the rebound pain criteria.

Secondary

Measure	Time frame	Description
Sleep Quality	From 1 day before surgery to postoperative day 7	Sleep quality will be assessed using a 6-item sleep questionnaire (scored 1-6, where 1 = best and 6 = worst sleep quality), covering the night before surgery and the first 7 nights postoperatively.
Patient Satisfaction with Pain Management	Postoperative day 7 (via telephone follow-up)	Patients will rate their satisfaction with postoperative pain control on a 5-point Likert scale (1 = not at all satisfied, 5 = completely satisfied).
Total Rescue Analgesic Consumption	Within 48 hours after surgery	The total dose of rescue opioid analgesics administered within the first 48 hours postoperatively will be recorded in milligrams.
Time to First Rescue Analgesia	Within 48 hours after surgery	Time elapsed from the end of surgery to the first administration of rescue analgesia will be recorded.

Countries

Turkey (Türkiye)

Outcome results