Neuropathic pain after orthopaedic surgery with continuous peripheral nerve block

Abstract

INTRODUCTION. Continuous peripheral nerve blocks (cPNBs) have shown favourable post-operative pain control results but may be associated with a risk for long-term neurological complications. This study sought to examine factors associated with persistent post-operative pain and potential neuropathy after orthopaedic lower-limb surgery with the use of post-operative cPNB. METHODS. Patients who underwent lower limb orthopaedic procedures with cPNBs between November 2021 to May 2022 were included. Patient demographics and perioperative data were noted. At discharge, patients completed the PainDetect (PD) questionnaire and were followed up six months after discharge. RESULTS. Seventy-seven patients with a total of 171 catheters completed the follow up. The median time to follow-up was 214 days after catheter removal, and 18 patients (23%) had a PD score ≥ 13. Univariate analysis showed that multiple variables were associated with a PD score ≥ 13 at the six-month follow-up. Multiple logistic regression showed that a high PD score at discharge, high BMI and longer duration of cPNBs were associated with higher risk of having a PD score ≥ 13 at the six-month follow-up. CONCLUSION. Several factors were associated with a higher risk of having possible neuropathy after six months. BMI, duration of catheter and PD score at discharge were correlated with risk of possible neuropathic pain. FUNDING. None. TRIAL REGISTRATION. The study was a quality control project and therefore did not require registration under Danish law.