Nerve Block Resolution Time Display and Pain Complaints

Peripheral nerve blocks are commonly used to provide perioperative pain relief after orthopedic surgery, but some patients experience rebound pain as the block resolves. Limited retention of verbal instructions may leave patients unprepared for the expected timing of nerve block resolution. This prospective, randomized study will enroll adults undergoing orthopedic surgery for a fracture who receive a preoperative nerve block as part of standard clinical care. Participants will be assigned to standard verbal communication alone or standard verbal communication plus a written display of the anticipated nerve block resolution time placed on the patient's splint. All other clinical care will remain unchanged. Demographic and postoperative information will be collected through medical record review. The study is intended to determine whether a persistent visual reminder improves preparedness and is associated with fewer postoperative pain-related complaints.

• Physical display (Other): Minimal intervention of a written physical display of anticipated nerve block resolution time on the patient's splint. This intervention will be supplemental to the standard communication regarding expected nerve block duration and postoperative pain management strategies. The intervention will not change any other aspect of clinical care.

Primary outcomes

• Rate of postoperative pain-related complaints in each group [From time of nerve block administration until the time of first documented pain-related phone call or 48 hours from nerve block administration, whichever came first.]: To evaluate whether physically displaying the expected nerve block resolution time on patients' splints reduces the rate of postoperative pain-related complaints. The rate will be measured as the percentage of patients in each study group who initiate at least 1 pain-related phone call within 48 hours of nerve block administration. Pain-related phone calls will be identified through patient chart review up to 48 hours after nerve block administration. Data will be compared between the interventional and control groups. The unit of measurement will be percentage of patients.

Secondary outcomes

• Age and postoperative pain-related complaints [From time of enrollment until the time of first documented pain-related phone call or 48 hours from nerve block administration, whichever came first.]: To evaluate the correlation between patient age and the rate of postoperative pain-related complaints. Age will be obtained by chart review and measured in years. The rate of postoperative pain-related complaints will be calculated as the percentage of patients within each age group who initiate at least 1 pain-related phone call within 48 hours of nerve block administration. Pain-related phone calls will be identified through patient chart review up to 48 hours after nerve block administration.
• Sex and postoperative pain-related complaints [From time of enrollment until the time of first documented pain-related phone call or 48 hours from nerve block administration, whichever came first]: To evaluate the correlation between patient sex and the rate of postoperative pain-related complaints. Sex will be obtained by chart review and recorded as a categorical variable. The rate of postoperative pain-related complaints will be calculated as the percentage of patients within each sex who initiate at least 1 pain-related phone call within 48 hours of nerve block administration. Pain-related phone calls will be identified through patient chart review up to 48 hours after nerve block administration.
• Race and postoperative pain-related complaints [From time of enrollment until the time of first documented pain-related phone call or 48 hours from nerve block administration, whichever came first]: To evaluate the correlation between patient race and the rate of postoperative pain-related complaints. Race will be obtained by chart review and recorded as a categorical variable. The rate of postoperative pain-related complaints will be calculated as the percentage of patients within each race who initiate at least 1 pain-related phone call within 48 hours of nerve block administration. Pain-related phone calls will be identified through patient chart review up to 48 hours after nerve block administration.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

1. Age 18 years or older
2. Present with a fracture and will subsequently undergo an operation with the Medical University of South Carolina Department of Orthopaedic Surgery
3. Will receive a preoperative nerve block as part of their standard clinical care

Exclusion Criteria:

1. More than one fracture
2. Cognitive impairment or inability to provide informed consent
3. Declines or is unwilling to provide informed consent
4. Currently imprisoned
5. Patients who self-report being pregnant during eligibility screening