Efficacy of Erector Spinae Plane Block Versus Infraclavicular Subomohyoid Block in Shoulder Surgery

Ain Shams University

Status and phase: Unknown; Phase 2; Phase 1

Conditions: Postoperative Pain; Shoulder Pain

Treatments: Procedure: Infraclavicular subomohyoid (ISO) block; Procedure: Erector spinae block

Study type: Interventional

Funder types: Other

Identifiers

NCT04183244

FMASU R 57/2019

Details and patient eligibility

About

The study aimed to compare Erector Spinae Plane (ESP) block versus infraclavicular subomohyoid (ISO) block in the provision of efficacy of either technique in postoperative analgesia in shoulder surgery, aiming to testing the safety of each block in terms of incidence of complications. Patients will be randomly divided into two groups, Group E will receive Erector spinae block and group I will receive infraclavicular subomohyioid block. The local anesthetic solution that will be used in both blocks will be a total volume of 30 mls 0.25%bupivacaine plus 3mg preservative free Dexamethasone. The time between recovery from anesthesia and first pain experienced, as verified by NRS ≥ 3 and first need of a rescue analgesic, will be defined as the duration of analgesia. The total dose of intravenous morphine (the rescue analgesic) used over 24 h postoperatively will be recorded.

Enrollment: 80 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients, above 18 years old.
• ASA physical status I
• Scheduled for shoulder surgery

Exclusion criteria

• Morbid obese.
• Previous surgery in the same shoulder.
• History of psychiatric disorder.
• Pulmonary disease.
• Contraindication to regional nerve block (e.g. skin infection at the puncture site, coagulopathy).
• Allergy to any of medications that will be used

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

Erector spinae block

Active Comparator group

Description:

Ultrasound guidance will be used to visualize the transverse processes of T2 and the overlying muscles. Under sterile conditions, a 5-cm, 21-gauge needle will be inserted using the out-of-plane technique parallel to the sagittal plane directly over the transverse process,then 30mL of the local anesthetic solution will be injected and observed for the linear spread of LA the under direct ultrasound visualization

Treatment:

Procedure: Erector spinae block

infraclavicular subomohyoid block

Active Comparator group

Description:

Performing posterior approach infraclavicular BP block followed by subomohioid block via the same puncture site under ultrasound guidance.

Treatment:

Procedure: Infraclavicular subomohyoid (ISO) block