A Comparison Between Ultrasound Guided Suprascapular Nerve Block Versus Ultrasound Guided Interscalene Brachial Plexus Block on Respiratory Mechanics in Patients Undergoing Arthroscopic Shoulder Surgery: A Randomized Controlled Study
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Benha University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- visual analogue score
Overview
Brief Summary
Diaphragmatic dysfunction can be detected as a decrease in forced vital capacity (FVC) and forced expiratory volume at 1 s (FEV1) on spirometry or as lower diaphragmatic excursion (DE) on US, the latter having become the gold standard in thoracic assessment.
Detailed Description
Severe intraoperative and postoperative pain associated with arthroscopic shoulder surgery has high incidence reaching up to 45%; it is often significant enough to interfere with initial recovery and rehabilitation.
Shoulder arthroscopy is becoming more common, representing the second most common Orthopedic surgery after knee arthroscopy . Interscalene brachial plexus block (ISB) is the gold standard analgesic technique for shoulder surgeries with success rates of 87% to 100%, but it also blocks the phrenic nerve (C3-C5).
Suprascapular nerve block via the anterior approach (SSB-A) is performed distally at the trunk/division level of the brachial plexus, thereby potentially sparing the phrenic nerve and minimising many adverse effects of ISB
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Double (Participant, Outcomes Assessor)
Masking Description
The patients, outcome assessors were blinded to the group allocation,
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •aged (18-65 years)
- •American Society of Anesthesiologists (ASA) physical status I or II
- •scheduled for elective arthroscopic shoulder surgery
Exclusion Criteria
- •pre-existing respiratory,
- •cardiac, renal, neurological, or hepatic disease, neuropathy affecting brachial plexus
- •contraindication to peripheral nerve block (e.g., coagulopathy),
Outcomes
Primary Outcomes
visual analogue score
Time Frame: Postoperative pain was assessed using VAS at Postoperative care unit, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, and 24hours after block administration postoperatively
The visual analogue score (VAS) was used (0 indicating no pain and 10 indicating worst unbearable pain) at rest and upon flexion for assessment of pain intensity upon arrival to the PACU
Secondary Outcomes
- Patient satisfaction(24 hours postoperatively)
Investigators
Ramy Mousa
Professor
Benha University