Ultrasound Guided Interscalene, Suprascapular and Anterior Glenoid Nerve Blocks on Diaphragmatic Excursion and Analgesia Following Arthroscopic Shoulder Surgery

Tanta University

Status: Enrolling

Conditions: Suprascapular Nerve Block; Arthroscopic Shoulder Surgery; Diaphragmatic Excursion; Anterior Glenoid Nerve Block; Interscalene Block; Analgesia

Treatments: Other: Interscalene brachial plexus block; Other: Anterior glenoid block; Other: Suprascapular nerve block + Anterior glenoid block; Other: Suprascapular nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT07090733

36265MD/12/24

Details and patient eligibility

About

This study aims to evaluate the diaphragmatic movement and postoperative analgesia following anterior glenoid, suprascapular, and interscalene nerve blocks in patients undergoing elective arthroscopic shoulder surgery.

Full description

Arthroscopic shoulder surgery is a key approach for diagnosing and treating many shoulder disorders. Nevertheless, 30-70% of patients often experience moderate to severe pain, especially at 48 h after the operation, which affects rapid recovery.

The interscalene brachial plexus block (ISB) remains the gold standard for providing analgesia after shoulder surgery. Suprascapular nerve block (SSNB) is the most commonly used regional nerve block. Seventy percent of the sensory nerve fibers of the shoulder joint are innervated by the suprascapular nerve (SSN), with the supraspinatus and infraspinatus being directly innervated by the SSN.

Enrollment: 80 estimated patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 21 to 65 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I or II.
• Scheduled for arthroscopic shoulder surgery.

Exclusion criteria

• Patient's refusal to participate.
• Patients with a history of allergy to local anesthetics.
• Patients with a history of chronic use of painkillers.
• Patients presented with mental dysfunction.
• Patients with coagulation disorders.
• Patients presented with skin or soft tissue infection at the proposed site of needle Insertion.
• Pregnant Patients.
• Patients with Chronic Obstructive Pulmonary Disease (COPD) or a Body Mass Index (BMI) of more than 40.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 4 patient groups

Group I

Active Comparator group

Description:

Patients will receive general anesthesia, plus an ultrasound-guided Interscalene brachial plexus block (ISB) with the injection of 15 mL of 0.25% bupivacaine. Patients will receive general anesthesia plus an ultrasound-guided suprascapular nerve block (SSNB)

Treatment:

Other: Interscalene brachial plexus block

Group II

Experimental group

Description:

Patients will receive general anesthesia plus an ultrasound-guided suprascapular nerve block (SSNB) with injection of 15 ml of 0.25% bupivacaine.

Treatment:

Other: Suprascapular nerve block

Group III

Experimental group

Description:

Patients will receive general anesthesia plus an ultrasound-guided anterior glenoid block with injection of 15 ml of 0.25% bupivacaine.

Treatment:

Other: Anterior glenoid block

Group IV

Experimental group

Description:

Patients will receive general anesthesia, along with a total volume of 30 mL of bupivacaine 0.25%, divided into 15 mL of Bupivacaine 0.25% for ultrasound-guided SSNB and 15 mL of Bupivacaine 0.25% for ultrasound-guided anterior glenoid block.

Treatment:

Other: Suprascapular nerve block + Anterior glenoid block