Erector Spinae Plane Versus Interscalene Blocks for Shoulder Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Anesthesia, Local
- Sponsor
- Stanford University
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Pain score
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The goal of this study is the evaluation of erector spinae plane (ESP) blocks as an alternative to interscalene brachial plexus nerve blocks for rotator cuff repair and total shoulder arthroplasty procedures. Currently, single shot interscalene nerve blocks are performed for rotator cuff repair surgeries, and interscalene nerve catheters are placed for total shoulder arthroplasty surgeries. Erector spinae plane blocks are commonly used as part of the anesthetic plan for other surgeries, but less so for shoulder surgeries. The investigators would like to study whether an ESP block can provide similar pain control compared to an interscalene nerve block, with less risk of upper extremity motor block and phrenic nerve block.
Investigators
Chi-Ho Ban Tsui
Professor of Anesthesiology, Perioperative and Pain Medicine
Stanford University
Eligibility Criteria
Inclusion Criteria
- •All adult patients (18 years and over) scheduled for rotator cuff surgery or total shoulder arthroplasty surgery requiring a nerve block as part of their anesthetic care
Exclusion Criteria
- •concomitant life-threatening injuries and other concomitant injuries causing significant pain.
- •pregnancy,
- •any condition impairing patient's ability to consent to participation in study
- •an existing condition contraindicating a nerve block, i.e. nerve injury, existing bleeding disorder
- •infection in the vicinity of the block, and patient refusal.
Outcomes
Primary Outcomes
Pain score
Time Frame: 48 hours
Pain scores for all patients will be recorded through the first 48 hours postoperatively using the Numeric Rating scale (ranging from 0 to 10, 0 is no pain and 10 is the worst imaginable pain).
Incidence of diaphragmatic paresis or paralysis
Time Frame: Before block placement, and 30 minutes after catheter is bolused in recovery
Change in diaphragmatic excursion (measured bilaterally using ultrasonography) from before block placement to 30 minutes after catheter is bolused in recovery
Secondary Outcomes
- Brachial plexus motor exam change(Before block placement, and 30 minutes after catheter is bolused in recovery)
- Incentive spirometry volume change(24 hours)
- Adverse effects(72 hours)
- Opioid Consumption(48 hours)
- Patient satisfaction(72 hours)
- Brachial plexus sensory exam change(Before block placement, and 30 minutes after catheter is bolused in recovery)