[Rebound pain-From definition to treatment]

Area of Science:

• Anesthesiology
• Pain Management
• Pharmacology

Background:

• Rebound pain is an excessive pain sensation post-regional anesthesia, exceeding typical surgical wound pain.
• The causes of rebound pain remain unclear, with limited targeted treatment recommendations.
• This phenomenon has gained research attention in the last decade.

Purpose of the Study:

• To provide an overview of current research on rebound pain.
• To present pathophysiological theories and discuss prophylaxis and treatment strategies.
• To summarize definitions, pathophysiology assumptions, and treatment recommendations from existing literature.

Main Methods:

• A review of publications on rebound pain from 2005 to May 2021 in PubMed.
• Evaluation of 22 original papers focusing on definitions, occurrence, and treatment options.
• Summarization of authors' definitions, pathophysiology assumptions, and treatment recommendations.

Main Results:

• No uniform definition of rebound pain exists among professional societies.
• The pathophysiology of rebound pain is not yet clearly identified.
• Early administration of pain medication (e.g., NSAIDs) before nerve block cessation and dexamethasone as an adjuvant show positive effects.
• Comprehensive patient information regarding this side effect is crucial for proper pain classification.

Conclusions:

• Current understanding of rebound pain pathophysiology and treatment is limited.
• Early NSAID administration and dexamethasone show potential in mitigating rebound pain.
• Further targeted studies, particularly on adjuvants, are necessary to improve patient comfort and acceptance of regional anesthesia.