Efficacy of the C8 Nerve Root Block During Interscalene Block for Anesthesia of the Posterior Aspect of the Shoulder

Daegu Catholic University Medical Center

Status: Completed

Conditions: Shoulder Pain; Brachial Plexus Block

Treatments: Procedure: Conventional interscalene block; Procedure: Interscalene block with C8 root block; Drug: 0.75% ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT03487874

CR-18-018

Details and patient eligibility

About

This study evaluates the effects of selective 8th cervical nerve root block during interscalene brachial plexus block on the relief of pain intensity upon the introduction of a posterior portal during arthroscopic shoulder surgery. The 5th to 7th cervical nerve roots will be blocked in half of participants, while the 5th to 8th cervical nerve roots will be blocked in the other half.

Full description

By blocking only the 5th to 7th cervical nerve blocks, conventional interscalene brachial plexus block spares the 8th cervical and 1st thoracic dermatomes which innervate the posterior aspect of the shoulder. To visualize the shoulder joint space during shoulder arthroscopic surgery, the introduction of a posterior portal is essential. However, conventional interscalene brachial plexus block cannot effectively relieve the pain caused by its insertion due to sparing of the 8th cervical and 1st thoracic dermatomes. The addition of the 8th cervical nerve root block to conventional interscalene brachial plexus block decreases pain intensity upon the introduction of a posterior portal.

Enrollment: 74 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists physical status 1 and 2
• Arthroscopic shoulder surgery under interscalene brachial plexus block

Exclusion criteria

• Patient refusal
• Contralateral hemidiaphragmatic paralysis or paresis
• Contralateral vocal cord palsy
• Severe pulmonary restrictive disease
• Coagulopathy
• Allergy to local anesthetics or history of allergic shock
• Difficulty communicating with medical personnel
• Peripheral neuropathy or neurologic sequelae on the operative limb

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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74 participants in 2 patient groups

Interscalene block with C8 root block

Experimental group

Description:

The 5th to 8th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine

Treatment:

Drug: 0.75% ropivacaine

Procedure: Interscalene block with C8 root block

Conventional interscalene block

Active Comparator group

Description:

The 5th to 7th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine

Treatment:

Drug: 0.75% ropivacaine

Procedure: Conventional interscalene block