An interventional study of Combined Costoclavicular and Suprascapular Nerve Block with Magnesium Sulfate and Interscalene Brachial Plexus Block with Magnesium Sulfate in Postoperative Pain, Shoulder Arthroscopy and Hemidiaphragmatic Paresis, sponsored by Assiut University. Not yet recruiting. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-11-05.
Sponsored by Assiut University · Not applicable, Interventional, and Treatment
Shoulder arthroscopy is a common outpatient procedure that can cause moderate to severe pain during the first 24 to 48 hours after surgery. An interscalene brachial plexus block (ISB) is widely used to provide pain relief, but it frequently causes temporary weakness or paralysis of the diaphragm (the main breathing muscle) by blocking the phrenic nerve, which can lead to shortness of breath. A combined costoclavicular and suprascapular nerve block (CCB-SSNB) has emerged as an alternative approach that numbs the shoulder while potentially preserving normal breathing and diaphragmatic function. Additionally, adding magnesium sulfate as an adjuvant medication to local anesthetics can help prolong and enhance pain relief.
The primary purpose of this study is to compare the pain-relieving efficacy and respiratory safety of ultrasound-guided combined CCB-SSNB versus standard ISB, both administered with magnesium sulfate as an adjuvant, in adult patients undergoing elective outpatient shoulder arthroscopy under general anesthesia.
Participants will be randomly assigned to one of two groups prior to surgery:
The primary outcome is the duration of pain relief, measured as the time from the end of surgery until the patient first requests rescue pain medication. Secondary outcomes include total opioid consumption during the first 24 hours postoperatively, pain scores at rest and during movement up to 48 hours, ultrasound evaluation of diaphragmatic movement to detect hemidiaphragmatic paresis, recovery time in the post-anesthesia care unit (PACU), patient satisfaction, and any block-related side effects or complications.
5,265 studies on the registry are indexed under Pain, Postoperative; 1,165 are open to participants now.
This study's planned enrollment of 60 is below the median of 75 across 4,496 interventional studies indexed under Pain, Postoperative.
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Patients receive a single-shot ultrasound-guided suprascapular nerve block (SSNB) with 10 mL of 0.5% bupivacaine and 100 mg magnesium sulfate, followed by an ultrasound-guided costoclavicular brachial plexus block (CCB) with 10 mL of 0.5% bupivacaine and 100 mg magnesium sulfate prior to induction of general anesthesia.
Procedure: Combined Costoclavicular and Suprascapular Nerve Block with Magnesium Sulfate
Patients receive a single-shot ultrasound-guided interscalene brachial plexus block (ISB) with 20 mL of 0.5% bupivacaine and 200 mg magnesium sulfate prior to induction of general anesthesia.
Procedure: Interscalene Brachial Plexus Block with Magnesium Sulfate
Under ultrasound guidance and sterile technique, patients receive a single-shot suprascapular nerve block (SSNB) with 10 mL of 0.5% bupivacaine and 100 mg magnesium sulfate, followed by a costoclavicular brachial plexus block (CCB) with 10 mL of 0.5% bupivacaine and 100 mg magnesium sulfate (total volume: 20 mL bupivacaine 0.5% + 200 mg magnesium sulfate) administered prior to general anesthesia induction.
Under ultrasound guidance and sterile technique, patients receive a single-shot interscalene brachial plexus block (ISB) with 20 mL of 0.5% bupivacaine and 200 mg magnesium sulfate administered prior to general anesthesia induction.
Time to First Postoperative Rescue Analgesic Request
Measured as the time (in hours) from the end of surgery (tracheal extubation) until the first administration of rescue analgesia, triggered when the patient requests pain relief or when the Numeric Rating Scale (NRS) pain score is \>= 4 out of 10. Rescue analgesia consists of intravenous morphine.
Time frame: Up to 48 hours postoperatively
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From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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