ArticleBritish journal of anaesthesia2025
Association of peripheral nerve blocks with increased postoperative pain and opioid use in orthopaedic surgery: a single-centre retrospective cohort study.
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of Rebound Pain After Orthopaedic Surgery With Peripheral Nerve Block: a Single-blinded Randomised Controlled Trial
Prevention of Rebound Pain After Orthopaedic Surgery With Peripheral Nerve Block: a Single-blinded Randomised Controlled Trial
Who cites it
8 citing papers in PubMed.
- Efficacy of erector spinae plane block with liposomal bupivacaine for postoperative analgesia in patients undergoing open spinal surgery: a randomized controlled trial.Frontiers in pharmacology · 2026Trial
- Analgesic and Hemodynamic Effects of Preoperative Ultrasound-Guided Brachial Plexus Block in Radius Fracture Surgery: A Propensity-Matched Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- Liposomal bupivacaine: is it the "code" to reduce postoperative opioid consumption?International journal of surgery (London, England) · 2026Article
- An Erythroid Gene Expression Signature in Preoperative Whole-Blood RNA-Seq Associated with Rebound Pain After Brachial Plexus Block: A Prospective Observational Study.Journal of pain research · 2026Article
- Rebound pain following peripheral nerve block in extremity fracture surgery: pathophysiological mechanisms based on the "Triple-Hit" model and multimodal preventive strategies.Frontiers in medicine · 2026Review
- Peripheral nerve blocks for perioperative analgesia: das Kind mit dem Bade ausschütten...throwing the baby out with the bathwater?British journal of anaesthesia · 2025Article
- Ethical Dilemmas and Approaches to Acute Pain Management in Patients With Substance Use Disorders.Cureus · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundPeripheral nerve blocks have become popular in orthopaedic surgeries to improve acute postoperative pain. However, studies are mixed on their effectiveness in decreasing postoperative opioid consumption. A more comprehensive analysis is necessary to understand if peripheral nerve blocks reduce postoperative opioid exposure and risk for opioid dependence.
methodsThis retrospective cohort study evaluated electronic health record data for adults undergoing orthopaedic surgery with general anaesthesia from 2016 to 2020 at the Massachusetts General Hospital. Linear models were fitted on propensity-weighted data to characterise the association between single injection peripheral nerve blocks and clinical outcomes. Our primary outcomes were maximum pain score and cumulative opioid dose, quantified in morphine milligram equivalents, administered in the PACU. Post-discharge outcomes associated with pain and opioid consumption were also evaluated.
resultsAmong 22 956 patients, peripheral nerve block administration was associated with lower maximum pain scores and lower probability of opioid administration in the PACU. However, it was associated with higher maximum pain scores and a 22.7% increase in opioid consumption during the hospital stay. Peripheral nerve blocks were associated with an increase in opioid prescriptions at 30 days after discharge, but no increase at 90 or 180 days, and with decreased chronic pain diagnoses 1 yr after operation.
conclusionsAlthough single injection peripheral nerve blocks were effective in reducing immediate postoperative pain and opioid consumption, they were associated with greater opioid consumption that could increase the risk for opioid dependence. Standardised protocols to mitigate the risk for rebound pain could help minimise postoperative opioid exposure.
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Registered trials
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