Effect of Local Anesthetic Dose on Interscalene Block for Shoulder Arthroscopy, Patient Satisfaction and Return of Handgrip Strength
Overview
- Phase
- Not Applicable
- Intervention
- Low Dose (20 ml) Local Anesthetic Volume for Interscalene Block
- Conditions
- Shoulder Arthroscopy
- Sponsor
- Hospital for Special Surgery, New York
- Enrollment
- 154
- Locations
- 1
- Primary Endpoint
- Handgrip Strength
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The purpose of this study is to determine if a decrease in the standard volume of local anesthetic used to numb your shoulder area before shoulder arthroscopy will provide adequate anesthesia for the procedure and decrease the amount of time until you are ready for discharge from the hospital.
Detailed Description
Traditionally, an interscalene block is done either with nerve stimulator or ultrasound guided using 40-60mL of local anesthetic. The study plans to investigate the difference in hand grip strength post-operatively in patients who will receive interscalene blocks with 40mL versus a lower dose (20mL) of local anesthetic. We suspect the lower dose will achieve adequate surgical anesthesia while creating less motor block and thus, increase patient satisfaction, present fewer complications or adverse affects and decrease time in the recovery room.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age: 18 - 80 years old
- •Surgical time \< 2.5 hours
- •ASA I, II or III
- •Shoulder arthroscopy
Exclusion Criteria
- •Age \< 18 or \> 80 years old
- •Chronic pain patients (on narcotics/opioids \> 3 months)
- •Open shoulder surgical procedure
- •BMI \> 40
- •Pre-existing neurological condition
- •Patient refusal of interscalene block
- •Severe respiratory disease or hemidiaphragmatic dysfunction
- •Allergy to any local anesthetics
- •Planned general anesthesia
Arms & Interventions
Low Dose (20 mL) Local Anesthetic
Intervention to be administered is a total volume of 20 mL local anesthetic containing a 1:1 mixture of 1.5% Mepivacaine: 0.5% Bupivacaine.
Intervention: Low Dose (20 ml) Local Anesthetic Volume for Interscalene Block
Control Dose (40 mL) Local Anesthetic
Intervention to be administered is a total volume of 40 mL local anesthetic containing a 1:1 mixture of 1.5% Mepivacaine: 0.5% Bupivacaine
Intervention: Control Dose (40 mL) Local Anesthetic Volume for Interscalene Block
Outcomes
Primary Outcomes
Handgrip Strength
Time Frame: Difference between between baseline and postoperative.
The primary outcome will be handgrip strength as measured by a dynamometer. A reading will be obtained at baseline (before the interscalene block) and 60 minutes post-operative.
Secondary Outcomes
- Patient Readiness to Discharge(Participants will be followed every 15 minutes post-surgery until discharged from the hospital (up to 180 minutes))
- Duration of Analgesia(Postoperative Day 2)
- Side Effects(Postoperative Day 2)