{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:32:20Z","timestamp":1772757140523,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Regional anaesthesia has the benefit of reducing the need for systemic analgesia and therefore, potentially reducing undesired side effects. With the end of the sensory nerve block however, many patients report severe pain that requires therapy with opioids and often compromise the initial opioid sparing effect. This study aimed to characterise the postoperative pain profile and the phenomenon of rebound pain after axillary brachial plexus anaesthesia (RA) compared to general anaesthesia (GA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Single\u2010centre observational, stratified cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was conducted at University Hospital Marburg from May 2020 until September 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>One hundred thirty\u2010two patients receiving elective hand and forearm surgery were enrolled in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Group RA received ultrasound\u2010guided brachial plexus anaesthesia via the axillary approach with 30\u2009mL of prilocaine 1% and 10\u2009mL ropivacaine 0.2%. Group GA received balanced or total intravenous general anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Primary endpoint were integrated pain scores (IPS) within 24\u2009h postoperatively. Secondary endpoints were pain scores (NRS 0\u201310), morphine equivalents, patient satisfaction, quality of recovery and opioid\u2010related side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred thirty\u2010two patients were analysed of which 66 patients received brachial plexus block and 66 patients received general anaesthesia. Following RA significantly lower IPS were seen directly after surgery (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and during the post\u2010anaesthesia care unit interval (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) but equalised after 3\u2009h at the ward. No overshoot in pain scores or increased opioid consumption could be detected. Patient satisfaction and postoperative recovery were comparable between both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The IPS and NRS was initially lower in the RA group, increased with fading of the block until equal to the GA group and equal thereafter. Although various definitions of rebound pain were met during this phase, the opioid sparing effect of regional anaesthesia was not counteracted by it. The incidence of episodes with uncontrolled, severe pain did not differ between groups. We found no clinical implications of rebound pain in this setting, since the RA group did not show higher pain scores than the GA group at any time point.<\/jats:p><jats:p>Trial Registration: German Clinical Trials Register (DRKS00021764).<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14318","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:14:55Z","timestamp":1693307695000},"page":"1414-1422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rebound pain and postoperative pain profile following brachial plexus block compared to general anaesthesia\u2014An observational study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6712-3812","authenticated-orcid":false,"given":"Ann\u2010Kristin","family":"Schubert","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Wiesmann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg Germany"},{"name":"Department of Anaesthesiology and Intensive Care Medicine Diakoneo Diak Klinikum Schw\u00e4bisch\u2010Hall  Schw\u00e4bisch\u2010Hall Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Volberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Riecke","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy Philipps University Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hinnerk","family":"Wulf","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanns\u2010Christian","family":"Dinges","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Marburg, Philipps University of Marburg  Marburg 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