Ultrasound Guided Block for Postoperative Analgesia in Arthroscopic Shoulder Surgery

Menoufia University

Status: Active, not recruiting

Conditions: Analgesia

Treatments: Procedure: Shoulder Block; Procedure: High Thoracic Erector Spinae Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06202430

122023ANET14

Details and patient eligibility

About

This study aimed to compare the efficacy of high thoracic-ESPB with shoulder block as analgesic options for arthroscopic shoulder surgery.

Primary outcome:

• 24-hour analgesic consumption.

Secondary outcomes:

• Postoperative pain evaluated by: Visual Analogue Pain Scale (VAS).
• Time to first rescue analgesia and total postoperative consumption of analgesia.
• Effect of the block on Hemodynamics.
• Adverse effects in the form of postoperative nausea and vomiting (PONV).
• Patient satisfaction.

Enrollment: 36 patients

Sex: All

Ages: 21 to 70 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All patients within the age range ≥ 21 to ≤ 70 years old.
• Body mass index (BMI) ≤ 35kg m2.
• ASA I, II of both sex

Exclusion criteria

• Refusal of the patient to the study.
• Infection at the site of injection.
• Previous known allergy to any drug used in the study by history.
• Renal disease [Creatinine. >3mg/dl.].
• Hepatic disease. [ALT>50U/L, AST >50U/L].
• Un cooperative or psychological unstable patients.
• Coagulopathy or anticoagulant therapy.
• Pregnancy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Ultrasound Guided High Thoracic Erector Spinae Plane Block

Active Comparator group

Description:

High Thoracic-ESPB The patient was placed in the lateral decubitus. Subsequently, an ultrasound (US)-guided aseptic technique, with a high-frequency linear probe enveloped in a sterile sheath containing a thin film of US gel, was used to locate the transverse process of T2. After LA skin infiltration, a 22-G block was inserted in a cephalocaudal direction until the space between the fascia of the erector spinae and the transverse process of T2 was identified. After negative aspiration, hydro dissection using 2 mL of saline was performed. Eventually, 30 mL of the LA bupivacaine 0.25% and epinephrine 5 µg/ mL was injected.

Treatment:

Procedure: High Thoracic Erector Spinae Plane Block

Ultrasound Guided Shoulder Block

Active Comparator group

Description:

Shoulder Block Suprascapular nerve block (SSNB) approach: A high-frequency linear probe was utilized across the supra-spinous fossa parallel to the spine of the scapula after skin cleaning with an antiseptic solution, if a deep block is required, a low frequency probe was required. A hyperechoic line was identified, followed by an acoustic shadow that corresponds to the floor of the supra-spinous fossa. The needle was progressed in plane from medial to lateral after local infiltration of the skin with 1% lidocaine. We directed the needle towards the lateral side of the supra-spinous fossa if the neuro-vascular bundle was not evident. After careful aspiration, 10 ml of 0.5% bupivacaine was injected under the supraspinatus muscle. Along with Axillary nerve block technique.

Treatment:

Procedure: Shoulder Block