Rebound pain after peripheral nerve blocks reduces the benefits of regional anesthesia and increases opioid consumption. This rebound pain most likely results from suboptimal pain management, as patients receiving a peripheral nerve block are typically not given scheduled opioid doses. Oral Patient Controlled Analgesia (PCA) consists of an oral morphine prescription that allows patients to self-administer doses based on their pain score.
This study will compare patients undergoing elective orthopaedic surgery under general anaesthesia or sedation with a peripheral nerve block, receiving oral morphine PCA either with or without additional scheduled oral morphine doses.
Patients scheduled for elective orthopaedic surgery on the upper limb
Patients scheduled for elective orthopaedic surgery on the lower limb.
Score ASA I-III; Patients aged over 18 years; Signed informed consent.
Surgery under general anaesthesia or under sedation
Refusal or inability to understand the informed consent
Allergy to any of the following medications: ropivacaine, paracetamol, ibuprofen, ketorolac, morphine,sufentanil, ondansetron, or dexamethasone
Patients with long term opioid treatment
Bleeding diathesis