Rebound pain after a single-shot peripheral nerve block typically arrives at night, 12 to 24 hours after surgery, when the patient is at home and has taken nothing because they felt no pain. Regular paracetamol and an anti-inflammatory where appropriate, started before the block fades, blunt it.
Patients should be told plainly that the block will wear off, roughly when, and what to take before it does.
- Tell patients the block will wear off, usually within a day, and the pain will return.
- Prescribe regular, not as-needed, simple analgesia for the first 48 hours.
- Advise taking the first doses before bedtime on the day of surgery.
- Give clear instructions for rescue analgesia and whom to call.
Why it matters
Patients judge their surgery partly by the first night, and that is when rebound pain strikes.
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