An interventional study of interscalene nerve block and anterior suprascapular nerve block in Interscalene Nerve Block, Anterior Suprascapular Nerve Block and Arthroscopic Shoulder Surgery, sponsored by Tanta University. Recruiting at 1 site in Egypt. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-09-06.
Sponsored by Tanta University · Not applicable, Interventional, and Treatment
This study is designed to investigate the post-operative analgesic effect of interscalene nerve block or anterior suprascapular nerve block compared to pericapsular nerve group block in patient undergoing elective arthroscopic shoulder surgery.
Shoulder arthroscopy is a common outpatient operation with an increasing number of indications and complexity. Early postoperative pain immediately following shoulder surgery is a major concern and cause of distress for patients and orthopedic surgeons. Adequate pain control is vital for all aspects of the patient's recovery.
Nowadays, several ultrasound -guided regional anesthesia methods are used for postoperative analgesia. Regional techniques such as interscalene and supraclavicular blocks are usually preferred for shoulder analgesia. Interscalene brachial plexus block (ISB) is the gold standard technique in this area.
Suprascapular nerve block (SSB) has been proposed as an alternative to the ISB in providing analgesia for shoulder surgeries as it has a lower likelihood of causing phrenic nerve blockade.
The pericapsular nerve group (PENG) block has been suggested to be safely applied for analgesia and can be part of surgical anesthesia, but alone is not sufficient for anesthesia in shoulder surgery. The block of this area did not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus.
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Exclusion Criteria:
30 patients will receive interscalene nerve block.
Procedure: interscalene nerve block
30 Patients will receive anterior suprascapular nerve block.
Procedure: anterior suprascapular nerve block
30 atients will receive pericapsular nerve group block around shoulder surgery
Procedure: Peri-capsular nerve group block
Patients will receive interscalene nerve block, in which the patient will be in supine position with the head turned to the contralateral side using an ultrasound scan to identify the C5 and C6 nerve roots between the scalene muscles.15 ml of 0.25% Bupivacaine will be deposited between the C5 and C6 nerve roots, within the interscalene groove using a 22 gauge-regional block needle.
Patients will receive anterior suprascapular nerve block, in which the patient will be in supine position with the head turned to the contralateral side, using an ultrasound the nerve will be traced as it diverges from the brachial plexus to lie under the omohyoid muscle in the supraclavicular fossa. 15 ml of 0.25% Bupivacaine will be deposited lateral to the suprascapular nerve, underneath the omohyoid muscle using a 22 gauge-regional block needle.
Patients will receive PENG block, in which the patient will be in supine position and the patient's arm will be placed in external rotation and abducted at 45 degrees, using an ultrasound the humeral head, the tendon of the subscapularis muscle and the deltoid muscle over it will be defined, 15 ml of 0.25% Bupivacaine will be placed between the deltoid muscle and subscapularis tendon using a 22 gauge-regional block needle.
the total opioid consumption.
Postoperative analgesia will be assessed by total opioid consumption and time till administration of first rescue analgesia will be recorded.
Time frame: 24-hour postoperatively
Plan to share: Yes — The data will be available upon reasonable request from the principal investigator
Supporting information: Study protocol, Sap
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