Interscalene Block Versus Costoclavicular Block for Shoulder Surgery

University of Chile

Status: Completed

Conditions: Shoulder Pain; Surgical Procedure, Unspecified; Pain, Postoperative; Diaphragmatic Paralysis

Treatments: Procedure: Costoclavicular Infraclavicular Block; Procedure: Interscalene Block

Study type: Interventional

Funder types: Other

Identifiers

NCT03411343

889/17

Details and patient eligibility

About

Interscalene brachial plexus block constitutes the analgesic criterion standard for shoulder surgery. However, it is associated with a high incidence of hemidiaphragmatic paralysis (HDP) that may not be tolerated by patients with chronic pulmonary disease. This randomized controlled trial (RCT) will compare ultrasound-guided interscalene block (ISB) and costoclavicular infraclavicular block (CCICB) in patients undergoing arthroscopic shoulder surgery.

The main outcome is static pain at 30 minutes after arrival in the post anesthesia care unit (PACU) as measured by a numerical rate scale (NRS) from 0 to 10. Our research hypothesis is that interscalene and costoclavicular infraclavicular blocks will result in equivalent postoperative analgesia at 30 minutes in the PACU. The equivalence margin is set at 2 points.

Enrollment: 44 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing arthroscopic shoulder surgery
• American Society of Anesthesiologists classification 1-3
• Body mass index between 20 and 35

Exclusion criteria

• Adults who are unable to give their own consent
• Pre-existing neuropathy
• Coagulopathy
• Obstructive or restrictive pulmonary disease
• Renal failure
• Hepatic failure
• Allergy to local anesthetics
• Pregnancy
• Prior surgery in the corresponding side of the neck or infraclavicular fossa
• Chronic pain syndromes requiring opioid intake at home

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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44 participants in 2 patient groups

Interscalene Block

Active Comparator group

Description:

Patients randomized to receive an intesrcalene block.

Treatment:

Procedure: Interscalene Block

Costoclavicular Infraclavicular Block

Experimental group

Description:

Patients randomized to receive a costoclavicular infraclavicular block.

Treatment:

Procedure: Costoclavicular Infraclavicular Block