Comparing Superior trunk of brachial plexus block and supraclavicular nerve block with shoulder pericapsular blocks and supraclavicular nerve block for post operative analgesia in patients undergoing shoulder arthroscopic surgeries.

Arthroscopicshoulder surgeries have the potential to cause severe postoperative pain.  Poor pain management leads to poor outcomes, with longer hospital stay and delayed functional recovery.  It also can cause an inability to participate in rehabilitation programs, leading to poor quality of life for the patients. Shoulder surgeries are amenable to either general anesthesia, regional anesthesia, or regional anesthesia with sedation. Opioid analgesics are commonly used for analgesia when nerve blocks are not used. Opioids are effective in relieving postoperative pain at rest but may increase post operative nausea and vomiting, somnolence, constipation, urinary retention, respiratory depression, and sleep disturbances. The interscalene brachial plexus block (ISB) has been reported to provide excellent post-operative analgesia but can produce side effects like phrenic nerve blockade resulting in diaphragmatic paresis causing respiratory distress to the patient. This necessitates the search for other nerve blocks which has similar analgesic efficacy as the ISB but without any associated complications. Injection around the superior trunk of the brachial plexus is an alternative technique that may reduce this risk. Along with supraclavicular block was suggested to provide effective anesthesia for shoulder surgery with a low rate of side-effects. The aim of this study is to compare the shoulder pericapsular blocks with superior trunk of brachial plexus block in relieving postoperative shoulder pain, intraoperative hemodynamic stability, avoiding motor block and allowing in early rehabilitation.

Patients undergoing shoulder surgeries will be randomized into 2 groups as

group A- will receive superior trunk of Brachial plexus block with supraclavicular nerve block.

group B- will receive shoulder capsular blocks with supraclavicular nerve block