Analgesic Efficacy and Respiratory Effects of Interscalene, Anterior Suprascapular, and Pericapsular Nerve Group Blocks in Shoulder Arthroscopy
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Pain scores
研究概览
简要总结
Interscalene block is widely accepted as the gold-standard regional analgesic technique for pain control after arthroscopic shoulder surgery. However, because this block is performed at the level of the brachial plexus roots, it may be associated with adverse effects such as phrenic nerve blockade and subsequent diaphragmatic dysfunction. These limitations have prompted the search for alternative regional anesthesia techniques that can provide effective postoperative analgesia while preserving respiratory function.
The anterior suprascapular block, which covers a broad dermatomal distribution of the shoulder region, has been shown in some studies to provide sufficient analgesia as a standalone technique. In addition, the pericapsular nerve group (PENG) block of the shoulder-applied around the anterior capsule and performed at a distance from critical neurovascular structures that may lead to serious complications-may represent another potential analgesic option following arthroscopic shoulder procedures.
Therefore, this study aims to evaluate alternative regional block techniques in comparison with the interscalene block and to contribute to the identification of an optimal analgesic strategy after arthroscopic shoulder surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with ASA scores I-II-III
- •Patients scheduled for elective arthroscopic shoulder surgery
- •Patients who have been informed about the study and have given written consent will be included.
排除标准
- •Those with a known allergy to local anesthetics
- •Those with an infection at the application site
- •Those with a severe coagulopathy disorder or anticoagulant use
- •Those with contralateral phrenic nerve palsy or a serious pulmonary diagnosis
- •Those with a history of chronic opioid use or neuropathic pain
研究组 & 干预措施
Interscalene block
In the preoperative period, 10 mL of 0.25% bupivacaine will be injected between C5 and C6 using an in-plane technique guided by a linear ultrasound (US) probe.
干预措施: Interscalene block (Procedure)
Anterior suprascapular block
A linear ultrasound probe will be positioned in the supraclavicular fossa, parallel to the clavicle. The suprascapular nerve will be identified as a hyperechoic oval structure deep to the omohyoid muscle and posterior-lateral to the brachial plexus. 10 mL of local anesthetic will be injected under the omohyoid muscle, around the suprascapular nerve.
干预措施: Anterior suprascapular block (Procedure)
Pericapsular nerve group (PENG) block
A linear ultrasound probe will be placed sagittally, near the axillary region, just below the coracoid process. The subscapularis muscle and its tendon will be visualized. The target area is the space between the deep fascia of the subscapularis muscle and the anterior surface of the shoulder joint capsule. The needle will pass the subscapularis muscle and be guided into the plane between the capsule and the muscle, where 20 mL of local anesthetic will be dispensed to block the articular branches innervating the capsule.
干预措施: Pericapsular nerve group (PENG) block (Procedure)
结局指标
主要结局
Pain scores
时间窗: First hour after the surgery
Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain) at the first postoperative hour.
次要结局
- Pain scores(First 24 hours after surgery)
- Forced vital capacity (FVC) (volume)(Perioperative period)
- Forced expiratory flow in 1 s (FEV1) (volume)(Perioperative period)
- FEV1/FVC(Perioperative period)
研究者
Musa Zengin
Principal İnvestigator
Ankara Etlik City Hospital