Rebound pain after a single-shot peripheral nerve block often arrives at night after a day-case discharge, when the block resolves suddenly and the patient has taken nothing. The pain can be worse than if no block had been given.
Scheduling regular paracetamol and an NSAID where suitable from the day of surgery, and telling the patient to take the next dose before sensation returns rather than waiting for pain, blunts the rebound.
- Tell patients roughly when the block is expected to wear off
- Prescribe regular, not as-needed, simple analgesia from the day of surgery
- Advise taking a dose before bedtime on the first night regardless of pain
- Provide a rescue analgesic and a contact number for the first night
Why it matters
Rebound pain on the first night is a common reason for poor experience and re-presentation after otherwise successful regional anaesthesia.
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