SynthesisAnaesthesia2026
Prophylactic interventions to prevent rebound pain after peripheral nerve block in adults: a systematic review and network meta-analysis of randomised controlled trials.
Synthesis in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Non-Biologic Injections in Sports Medicine.Current reviews in musculoskeletal medicine · 2026Review
- The quest to prevent rebound pain: clarity or uncertainty?Anaesthesia · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRebound pain after peripheral nerve block is recognised increasingly as a postoperative complication that may diminish the benefits of regional anaesthesia. We undertook a systematic review and network meta-analysis to evaluate pharmacological strategies for its prevention.
methodsWe searched relevant databases for randomised controlled trials in adults undergoing surgery with peripheral nerve blocks. The primary outcome was the incidence of rebound pain. Secondary outcomes were: timing and severity of rebound pain; time to first rescue analgesia; patient satisfaction; sleep disturbance; and intervention-related adverse effects.
resultsTwenty-four randomised controlled trials (2130 patients, eight interventions) were included. Intravenous dexamethasone had the highest probability of reducing rebound pain incidence (surface under the cumulative ranking curve 0.91) and was judged 'definitely superior' to control. Perineural dexamethasone and perineural dexmedetomidine ranked highest for delaying rebound pain and prolonging time to first rescue analgesia. Pre-emptive opioids were probably inferior to control. Certainty of evidence ranged from very low to moderate. Data for pain severity, patient satisfaction and sleep disturbance were reported inconsistently and could not be pooled. DISCUSSION: Intravenous dexamethasone was the most effective intervention for preventing rebound pain following single-injection peripheral nerve blocks. Perineural dexamethasone and dexmedetomidine showed benefit in delaying onset and prolonging analgesia. These findings support intravenous dexamethasone as a first-line prophylactic drug, while highlighting the need for adequately powered trials of alternative strategies.
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