Anterior and Posterior Approaches of Suprascapular Nerve Block

Not Applicable

Completed

• Conditions: Shoulder Pain; Postoperative Pain; Diaphragmatic Paralysis; Subomohyoid Suprascapular Nerve Block; Anterior Suprascapular Nerve Block; Suprascapular Nerve Block
• Interventions: Procedure: Posterior suprascapular block; Procedure: Anterior suprascapular block

• Registration Number: NCT05442814
• Lead Sponsor: Istanbul Medeniyet University

Brief Summary

Suprascapular nerve is a mixed motor and sensory peripheral nerve arising from the superior trunk of brachial plexus.The suprascapular nerve runs through the posterior triangle of the neck, anterior of the trapezius muscle and dorsal of the omohyoid muscle, in direction of the scapula. Suprascapular nerve block is performed by anterior and posterior approach. Posterior approach of the suprascapular nerve block has been shown for many years to provide effective analgesia in the shoulder region for the chronic and acute pain. There are studies showing that suprascapular block with anterior approach provides effective analgesia in shoulder arthroscopy.

The aim of our study was to compare anterior and posterior approaches of suprascapular nerve block in terms of analgesic efficacy and patient safety.

Detailed Description

This study is a prospective randomized clinical trial will be conducted between March 2022 and March 2023.Participant will divide into two groups as participant who underwent suprascapular nerve block with the anterior approach and participant who underwent suprascapular nerve block with the posterior approach. Bupivacaine 5 ml %0.5 will be injected both group. Diaphragmatic thickness fraction will be evaluated with ultrasound left and right 7.-8. subcostal anterior axillary border with the participant with the semi-sitting position. Diaphragmatic thickness fraction will measure before the block and after 30 minutes the surgery. Participants will administered intravenous morphine patient controlled analgesia for 24 hours stay. The amount of opioid analgesics given in both groups will be determined (in mg). Postoperative 4th, 6th, 12th, 24th hour Visual Analogue Scale scores of the participants and opioid consumptions until that hours will be evaluated. An addition participant will be determined according to the surgery.

Study Timeline

• Study Start: 2022-03-15
• Study First Submitted: 2022-04-18
• Study First Submitted QC: 2022-07-01
• Study First Posted: 2022-07-05
• Primary Completion: 2023-03-15
• Study Completion: 2023-03-15
• Status Verified: 2024-03
• Last Update Submitted: 2024-03-03
• Last Update Posted: 2024-03-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Patient who accepts to study protocol
• Scheduled for shoulder surgery
• Between the ages of 18 and 80

Exclusion Criteria

• Patients with coagulopathy
• Patients with a history of local anesthetic drug allergy and toxicity
• Patients with advanced organ failure
• Patients with mental retardation
• Patients with infection present at the injection site
• Patients with diaphragm paralysis
• Pregnant patients

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Posterior suprascapular block	Posterior suprascapular block	Suprascapular block performed by posterior approach
Anterior suprascapular block	Anterior suprascapular block	Suprascapular block performed by anterior approach

Primary Outcome Measures

Name	Time	Method
Postoperative pain at the first postoperatively 30th. Min.	The first postoperative 30 minutes	Visual analog scale (1-10): 1= no pain, 10= the worst pain ever feel.

Secondary Outcome Measures

Name	Time	Method
Diaphragmatic movements	Baseline (Before the block performed) and 30 minutes after the end of surgery	Ratio of diaphragm thickness in end-inspiration and end-expiration measured by ultrasonography
Postoperative pain at postoperative 4th. Hours	at postoperative 4th. Hours	Visual analog scale (1-10): 1= no pain, 10= the worst pain ever feel.
Postoperative opioid analgesic consumption (morphine)	postoperative 24 hours	milligram
Postoperative pain at postoperative 12th. Hours	at postoperative 12th. Hours	Visual analog scale (1-10): 1= no pain, 10= the worst pain ever feel.
Postoperative pain at postoperative 24th. Hours	at postoperative 24th. Hours	Visual analog scale (1-10): 1= no pain, 10= the worst pain ever feel.
Peroperatively opioid analgesic consumption (Remifentanil)	postoperative 0th.min	milligram
Postoperative pain at postoperative 6th. Hours	at postoperative 6th. Hours	Visual analog scale (1-10): 1= no pain, 10= the worst pain ever feel.

Trial Locations

Locations (1)

Istanbul Medeniyet University; 🇹🇷 Istanbul, Turkey