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Neuropathic pain after orthopaedic surgery with continuous peripheral nerve block
Phillip Kaasgaard Sperling1, Nicolai Launa2,3, Arash Ghaffari3
1Department of Anaesthesia and Intensive Care, Aalborg University Hospital.
Danish Medical Journal
|March 6, 2024
Summary
Continuous peripheral nerve blocks (cPNBs) can help with pain after surgery, but may lead to nerve issues. Higher BMI, longer block duration, and high pain scores at discharge increase the risk of persistent neuropathic pain six months later.
Area of Science:
- Orthopaedic Surgery
- Pain Management
- Neurology
Background:
- Continuous peripheral nerve blocks (cPNBs) offer effective post-operative pain relief.
- However, cPNBs may pose a risk for long-term neurological complications.
- Identifying risk factors for persistent pain and neuropathy is crucial.
Purpose of the Study:
- To investigate factors associated with persistent post-operative pain and potential neuropathy.
- To analyze outcomes after orthopaedic lower-limb surgery utilizing cPNBs.
Main Methods:
- Seventy-seven patients receiving cPNBs for lower limb orthopaedic surgery were included.
- Data on demographics and perioperative factors were collected.
- Patients completed the PainDetect (PD) questionnaire at discharge and were followed up for six months.
Main Results:
- At six months, 18 patients (23%) had a PD score ≥ 13, indicating possible neuropathic pain.
- Logistic regression revealed that a high PD score at discharge, elevated BMI, and longer cPNB duration were significant risk factors.
- Univariate analysis identified multiple variables associated with higher PD scores.
Conclusions:
- Persistent neuropathic pain after cPNBs is associated with specific factors.
- Body Mass Index (BMI), duration of catheter use, and discharge PD scores predict the risk of developing possible neuropathic pain.
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