Interscalene Versus Infraspinatus-Teres Minor Blocks for Arthroscopic Shoulder Surgery (ITM-ISB)

Ataturk University

Status: Enrolling

Conditions: Arthroscopic Shoulder Surgery

Treatments: Procedure: Infraspinatus-Teres Minor Block (ITM); Procedure: Interscalene Brachial Plexus Block (ISB)

Study type: Interventional

Funder types: Other

Identifiers

NCT07253740

ATAUNISHOULDER

Details and patient eligibility

About

This randomized controlled trial aims to compare the effectiveness of interscalene (ISB) and infraspinatus-teres minor (ITM) blocks for postoperative analgesia in patients undergoing elective arthroscopic shoulder surgery. The primary outcome is total 24-hour opioid consumption. Secondary outcomes include pain scores, hemidiaphragmatic paresis incidence and severity, duration of analgesia, and changes in lung function. Participants are randomized into ISB or ITM groups; blocks are performed under ultrasound guidance. Postoperative pain is managed with patient controlled analgesia(PCA).

Full description

This is a single-center, prospective, randomized clinical trial designed to compare the efficacy of Interscalene Brachial Plexus Block (ISB) and Infraspinatus-Teres Minor (ITM) interfascial block in patients undergoing elective unilateral arthroscopic shoulder surgery. The primary objective is to compare total 24-hour postoperative opioid consumption. Secondary objectives include the and pain scores, incidence and severity of hemidiaphragmatic paresis, duration of analgesia (from block completion to initiation of IV PCA), and postoperative pulmonary function changes.

This study aims to determine whether the ITM block provides comparable perioperative analgesia to the ISB block while potentially reducing hemidiaphragmatic paresis and pulmonary compromise.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The American Society of Anesthesiologists I-III
• Scheduled for elective unilateral arthroscopic shoulder surgery
• Provide written informed consent

Exclusion criteria

• Refusal to participate
• Allergy to study drugs
• Severe cardiac, renal, or hepatic disease
• Neurological deficit or neuropathy
• Anticoagulant therapy
• Pre-existing respiratory dysfunction
• Chronic shoulder pain or planned open surgery

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

---

60 participants in 2 patient groups

Interscalene Brachial Plexus Block (ISB)

Experimental group

Description:

Patients will receive ISB under ultrasound guidance prior to arthroscopic shoulder surgery using 15 ml 0.25% bupivacaine.

Treatment:

Procedure: Interscalene Brachial Plexus Block (ISB)

Infraspinatus-Teres Minor Block (ITM)

Experimental group

Description:

Patients will receive TM block under ultrasound guidance using 25 ml 0.25% bupivacaine between infraspinatus and teres minor muscles.

Treatment:

Procedure: Infraspinatus-Teres Minor Block (ITM)