Document Type : Review Article


1 Assistant Professor of Orthopaedics, Department of Orthopedics, School of Medicine,Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of anesthesiology, Faculty of medicine, Tabriz medical sciences, Islamic Azad University, Tabriz, Iran


Introduction: Regional anesthesia is considered an important tool in postoperative pain management while minimizing opioid use. However, post-operative recovery (characterized by peripheral nerve hyperalgesia) may reduce or completely block the effect of this change, since opioids may act better after the blockage is removed.

Material and Methods: This study was a systematic Review. We reviewed the published literature describing the pathophysiology and development of complications after peripheral artery dissection in orthopedic surgery patients. Search for related articles using PubMed, EMBASE, and Web of Science.

Results: We included 28 articles (n=28) in our review. Perioperative peripheral nerve considerations and other postoperative pain management for orthopedic surgery patients are discussed. Multimodal strategies such as preemptive analgesia, intra-articular or intravenous anti-inflammatory drugs, and adjuvants in vain block fluid before block failure will reduce the burden of rebound pain.

Conclusion: Additionally, educating the patient about the possibility of back pain is important to ensure proper use of pain relievers and to reduce the need for pain relief opioids. Understanding the effects of relapse and prevention of relapse is important to reduce the side effects associated with the use of opioids for regional anesthesia.


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