Analgesic Effect of Infraspinatus-teres Minor Block for Pre-emptive Analgesia in Patients Undergoing Shoulder Surgeries.

Zagazig University

Status: Enrolling

Conditions: Preemptive Analgesia

Treatments: Procedure: Infraspinatus teres minor block group; Procedure: Control group

Study type: Interventional

Funder types: Other

Identifiers

NCT06999460

1299

Details and patient eligibility

About

The aim of the study to evaluate the efficacy of the infraspinatus-teres minor (ITM) block in improving pre-emptive analgesia, reducing opioid consumption, and enhancing the overall analgesic effect in patients undergoing shoulder surgeries.

Full description

To compare between infraspinatus-teres minor versus control group (GA):

1. To measure analgesic parameters including: the total amount of rescue analgesic consumption (morphine) in the first 24 hours post-operatively in each group, duration of analgesia, and total amount of intraoperative fentanyl consumption and
2. To assess pain score by using numerical rate scale (NRS) at rest (static) and during passive or active movement of shoulder joint (dynamic).
3. To assess discharge time from post anesthesia care unit (PACU).
4. To assess side effects of systemic opioids (constipation, itching, dizziness, nausea and vomiting) and complications of infraspinatus-tere minor block.
5. Patients' satisfaction: The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points Likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia).

Enrollment: 60 estimated patients

Sex: All

Ages: 21 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• • Patients' acceptance.

  • Age: Adults aged 21-65 years old.
  • BMI: 25-30 kg/m2
  • Sex: both sexes (males or females).
  • Patients undergoing unilateral shoulder surgey under general anesthesia.
  • ASA (American Society of Anesthesiologists) physical status classification I to II.
  • Duration of the surgery < 3hours.

Exclusion criteria

• • Patients with contraindications to regional anesthesia (e.g. local or systemic infections, or severe neurological or muscular or bleeding disorders or patient on anticoagulant).

  • Allergy to study medications: bupivacaine or dexamethasone, or dexmedetomidine
  • Patients with severe cardiovascular, respiratory, renal, or hepatic diseases, uncontrolled diabetes , or those undergoing chronic opioid therapy.
  • Psychiatric disorders that hinder informed consent or study participation.
  • history of neurological diseases or conditions that would affect the efficacy of nerve blocks (e.g., neuropathy, spinal cord injury, or history of severe muscle weakness).
  • Patients with nerve injury or disease around the shoulder joint, including thoracic outlet syndrome, Multiple sclerosis, cervical disc disease with ipsilateral radiculopathy, or patients with abnormal sensory or motor function of the upper limb.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

*Group Infraspinatus teres minor block (ITM group)

Active Comparator group

Description:

Patients in this group will receive a unilateral ultrasound-guided Infraspinatus-teres minor (ITM) block with injection of local anesthetics (20 mL of bupivacaine 0.25% (50 mg), 50 mcg dexmedetomidine (0.5 ml) and 8 mg dexamethasone (2 ml)) before induction of general anesthesia

Treatment:

Procedure: Infraspinatus teres minor block group

Control group (group C)

Active Comparator group

Description:

Patients in this group will receive general anesthesia.

Treatment:

Procedure: Control group