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Morphine and/or Nalbuphine as Adjuvants in Ultrasound Guided Interscalene Block: for Shoulder Surgeries

Phase 2
Conditions
Rotator Cuff Tear
Interventions
Registration Number
NCT03034382
Lead Sponsor
Assiut University
Brief Summary

the aim of this study is to evaluate the duration of analgesia when either morphine or nalbuphine or both are used as adjuvants in sonar guided interscalene brachial plexus block for arthroscopic rotator cuff repair.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Patients scheduled for arthroscopic repair of rotator cuff muscle tear of the shoulder.
  • ASA physical status I - Ш.
Exclusion Criteria
  • Infection at the site of injection.
  • Coagulopathy or other bleeding diathesis.
  • Known allergy to drugs in the study
  • Preexisting neurologic deficits in the area to be blocked.
  • Inability to communicate with the investigator and the hospital staff.
  • History of chronic opioid use.
  • Morbid obesity BMI>40.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MorphineMorphine5 mg morphine in 5ml volume injected as adjuvants to 10 ml of lidocaine and epinephrine 1:400,000.
NalbuphineNalbuphine5 mg nalbuphine in 5ml volume injected as adjuvants to 10 ml of lidocaine and epinephrine 1:400,000.
Bupivacaine 0.5%Bupivacaine 0.5%10 ml of lidocaine 1% and epinephrine 1:400,000 and 5 ml of Bupivacaine 0.5% in interscalene block.
Morphine and NalbuphineMorphine5 mg morphine and 5 mg nalbuphine in 5 ml volume are injected as adjuvants to 10 ml of lidocaine and epinephrine 1:400,000. combination of 5 mg morphine and 5 mg nalbuphine in 5 ml volume are injected perineurally as adjuvants for 10 ml of lidocaine + epinephrine 1:400,000 in ultrasound guided interscalene block
Morphine and NalbuphineNalbuphine5 mg morphine and 5 mg nalbuphine in 5 ml volume are injected as adjuvants to 10 ml of lidocaine and epinephrine 1:400,000. combination of 5 mg morphine and 5 mg nalbuphine in 5 ml volume are injected perineurally as adjuvants for 10 ml of lidocaine + epinephrine 1:400,000 in ultrasound guided interscalene block
Primary Outcome Measures
NameTimeMethod
the total number of analgesic requests72 hours postoperative followup

the combination of opioid agonist and mixed agonist-antagonist peripherally prevents the development of early tolerance of the opioid agonist; thus the agonist would maintain the same efficacy and this will be obvious clinically by a reduction in the requests for supplementary analgesia.

Secondary Outcome Measures
NameTimeMethod
duration of analgesia72 hours followup

duration of analgesia when morphine or nalbuphine or both used in interscalene block using VAS.

patient satisfaction72 hours followup

- The patient satisfaction score. Patients were also asked to rate their satisfaction with the analgesia on a scale of 0-10 (0 for total dissatisfaction to 10 for total satisfaction).

The first time to ask for analgesics72 hours followup
sedation score72 hours followup

recorded every 4 hours; ranging from alert, drowsy, sleeping but responsive to verbal commands up to unarousable (we consider sedation score 3 or more as clinically significant sedation that mandate close patient observation every hour).

number of vomiting attacks72 hours followup

recorded every 4 hours. A vomiting attack was defined by events of vomiting that occurred in a rapid sequence (\<1 minute between events). If vomiting was separated by more than 1 minute; they will be considered to be separate attacks. Retching (the same as vomiting but without expulsion of gastric contents) was considered as vomiting. If the patient experienced vomiting; ondansetron 4 mg IV was given.

itching72 hours followup

Itching is assessed using an ordinal scale (0 = no itch, 1 = mild, 2 = moderate, 3 = severe).

Trial Locations

Locations (1)

Assiut University Hospitals

🇪🇬

Assiut, Egypt

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