Comparison of Postoperative Analgesic Efficacy of Serratus Posterior Superıor Intercostal Plane Block and Combination of Interscalene Brachial Plexus Block and Superfisial Plexus Block in Shoulder Arthroscopies
Overview
- Phase
- Not Applicable
- Intervention
- Serratus posterior superior intercostal plane block
- Conditions
- Shoulder Arthroscopy
- Sponsor
- Ankara Etlik City Hospital
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- Intraoperative remifentanil consumption
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Shoulder arthroscopy is one of the frequently performed surgical procedures today. After shoulder surgery, ensuring sufficent analgesia is necessary for both the patient's comfort and for the early and regular performance of the required postoperative rehabilitation exercises. Nerve blocks provide better pain control, opioid consumption in the postoperative period, and consequently have advantages such as fewer side effects and lower risks of pulmonary and cardiac complications. Multimodal analgesia approach is preferred for patients undergoing shoulder arthroscopy. Along with intravenous analgesic agents, peripheral nerve blocks (applied to every suitable and consenting patient) are performed based on patient preference. This study aims to compare the analgesic efficacy in the postoperative period of patients undergoing shoulder arthroscopy with a combination of interscalene brachial plexus block and superficial cervical plexus block with serratus posterior superior intercostal plane block.
Investigators
Muruvvet Taskir Turan
Principal investigator
Ankara Etlik City Hospital
Eligibility Criteria
Inclusion Criteria
- •18 to 65 years old
- •American Society of Anesthesiologists (ASA) physical status I-II-III
- •Body mass index 18 to 30 kg/m2
- •Elective shoulder arthroscopy surgery
Exclusion Criteria
- •Under 18 and over 65
- •ASA score IV and above
- •Advanced co-morbidity
- •History of bleeding diathesis
- •BMI under 18 kg/m2 and over 30 kg/m2
- •Patient refusing the procedure
- •Patients who have previously undergone shoulder surgery
- •Chronic opioid or analgesic use
- •Patients who will operate under emergency conditions
- •Patients who will not undergo shoulder surgery
Arms & Interventions
Serratus posterior superior intercostal plane block
With the patient in the prone position the skin is disinfected .Linear USG probe is placed on the spine of the scapula using an in-plane technique and moved medially. The 3rd rib is identified just on the medial scapular border. After visualizing the trapezius, rhomboid major, and serratus posterior superior muscles (from top to bottom) under USG guidance, a 22-G X 80-mm block needle is directed caudally and advanced until it contacted the rib. To confirm and obtain a plane between the serratus posterior superior and intercostal muscles, hydrodissection is performed using 2 ml of isotonic solution. After the needle site is confirmed, 30 ml of 0.25% bupivacaine is injected ; the local anesthetic spread is confirmed by USG.
Intervention: Serratus posterior superior intercostal plane block
Interscalene brachial plexus block and superficial cervical plexus block
İBPB:While the patient is in the supine position, the ultrasound probe is placed on the cricoid cartilage and moved laterally to visualize the trachea, thyroid, carotid artery, internal jugular vein, and sternocleidomastoid muscle. The brachial plexus is identified by directing it posteriorly and laterally between the anterior and middle scalene muscles. After entering between the roots using the in-plane technique and confirming the location with a 2 ml isotonic sodium injection, 20 ml of 0.25% bupivacaine is injected. SCPB:While the patient is in the supine position, the ultrasound probe is placed at the midpoint of the sternocleidomastoid (SCM) muscle. The cervical plexus is visualized deep to the posterior border of the SCM muscle. The needle is inserted deep to the SCM, directed towards the levator scapula. After confirming the location with a 2 ml isotonic sodium injection, 10 ml of 0.25% bupivacaine is injected.
Intervention: Interscalene brachial plexus block and superficial cervical plexus block
Outcomes
Primary Outcomes
Intraoperative remifentanil consumption
Time Frame: During The intraoperatif period
The amount of remifentanil that patients need to maintain anesthesia during the intraoperative period will be recorded
Secondary Outcomes
- Pain scores(First 24 hours after surgery)