ISB, SSNB, and PENG Block for Arthroscopic Shoulder Surgery

Tanta University

Status: Enrolling

Conditions: Arthroscopic Shoulder Surgery; Anterior Suprascapular Nerve Block; Interscalene Nerve Block

Treatments: Procedure: interscalene nerve block; Procedure: anterior suprascapular nerve block; Procedure: Peri-capsular nerve group block

Study type: Interventional

Funder types: Other

Identifiers

NCT05739201

36264MS18/1/23

Details and patient eligibility

About

This study is designed to investigate the post-operative analgesic effect of interscalene nerve block or anterior suprascapular nerve block compared to pericapsular nerve group block in patient undergoing elective arthroscopic shoulder surgery.

Full description

Shoulder arthroscopy is a common outpatient operation with an increasing number of indications and complexity. Early postoperative pain immediately following shoulder surgery is a major concern and cause of distress for patients and orthopedic surgeons. Adequate pain control is vital for all aspects of the patient's recovery.

Nowadays, several ultrasound -guided regional anesthesia methods are used for postoperative analgesia. Regional techniques such as interscalene and supraclavicular blocks are usually preferred for shoulder analgesia. Interscalene brachial plexus block (ISB) is the gold standard technique in this area.

Suprascapular nerve block (SSB) has been proposed as an alternative to the ISB in providing analgesia for shoulder surgeries as it has a lower likelihood of causing phrenic nerve blockade.

The pericapsular nerve group (PENG) block has been suggested to be safely applied for analgesia and can be part of surgical anesthesia, but alone is not sufficient for anesthesia in shoulder surgery. The block of this area did not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients.
• ASA class I and II and scheduled for elective shoulder arthroscopy.

Exclusion criteria

• Patient who refuses the regional anesthesia technique.
• History of allergy to local anesthetics.
• Local infection at the site of the block.
• History of Pre-existing major organ dysfunction such as hepatic and renal failure.
• History of pre-existing lung disease (COPD, uncontrolled asthma).
• Preexisting upper extremity neurological abnormality or neuropathy.
• Difficulties in comprehending (NRS).
• Chronic opioid users (opioid intake more than 3 months).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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90 participants in 3 patient groups

Group (I)

Active Comparator group

Description:

30 patients will receive interscalene nerve block.

Treatment:

Procedure: interscalene nerve block

Group (II)

Active Comparator group

Description:

30 Patients will receive anterior suprascapular nerve block.

Treatment:

Procedure: anterior suprascapular nerve block

Group (III)

Active Comparator group

Description:

30 atients will receive pericapsular nerve group block around shoulder surgery

Treatment:

Procedure: Peri-capsular nerve group block