Upper Trunk Block Versus Costoclavicular Block For Arthroscopic Shoulder Surgery

Bezmialem Vakif University

Status: Enrolling

Conditions: Phrenic Nerve Paralysis; Shoulder Pain

Treatments: Procedure: Diaphragmatic function assessment; Procedure: Costoclavicular block; Procedure: Cervical plexus blockade; Procedure: Upper trunk block

Study type: Interventional

Funder types: Other

Identifiers

NCT04194385

71306642-050-05-04-

Details and patient eligibility

About

Interscalene brachial plexus block is known as the gold standard for analgesia after shoulder surgery, but limits the use of ipsilateral phrenic nerve paralysis. Recently, interest in potential diaphragm-sparing alternative blocks has increased for patients undergoing shoulder surgery.Two of these blocks are upper trunk block (UTB) and costoclavicular brachial plexus (CCBPB) block. This randomized controlled trial will compare ultrasound-guided UTB and CCBPB in patients undergoing arthroscopic shoulder surgery.

The main outcome is pain intensity score at 30 minutes after arrival in the post anesthesia care unit (PACU) as measured by a numerical rating scale (NRS) from 0 to 10. The investigators research hypothesis is that UTB and CCBPB will result in equivalent postoperative analgesia at 30 minutes in the PACU.

Enrollment: 50 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. American Association of Anesthesiologists (ASA) physical status I - III
2. BMI 20 to 35 kg / m2
3. Patients scheduled for elective arthroscopic shoulder surgery

Exclusion criteria

1. Patients who refuse to participate in the study,
2. Pre-existing (obstructive or restrictive) lung disease,
3. Coagulopathy,
4. Sepsis,
5. Hepatic or renal insufficiency,
6. Pregnancy
7. Allergy to local anesthetic drugs,
8. Chronic pain condition requiring opioid intake at home,
9. Surgery in the neck or infraclavicular region
10. BMI above 40.
11. History of psychiatric diseases needing treatment.
12. Failure of nerve block performed in the preoperative block room
13. Substance abuse history

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

Upper trunk block

Active Comparator group

Description:

In the supraclavicular region, UTB will be applied with 20 ml % 0.25 bupivacaine with 5 mcg/ml epinephrine.

Treatment:

Procedure: Upper trunk block

Procedure: Cervical plexus blockade

Procedure: Diaphragmatic function assessment

Costoclavicular brachial plexus block

Active Comparator group

Description:

In the infraclavicular region, CCBPB will be applied with 20 ml % 0.25 bupivacaine with 5 mcg/ml epinephrine.

Treatment:

Procedure: Cervical plexus blockade

Procedure: Costoclavicular block

Procedure: Diaphragmatic function assessment