Shoulder Anterior Capsule Block Combined With Suprascapular Nerve Block Versus Interscalene Block as a Sole Anesthetic Technique for Shoulder Arthroscopy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by using Visual Analogue Scale (VAS)
研究概览
简要总结
Evaluation of shoulder anterior capsule nerve block combined with suprascapular nerve block as an adequate sole anesthetic technique in shoulder arthroscopic surgeries without significant affection of motor power and pulmonary function.
详细描述
Ultrasonographic peripheral nerve block has been a popular technique not only for pain management but also for surgical anesthesia especially in patients with comorbidities, avoiding complications associated with general anesthesia (airway-difficulties, hemodynamic instability, etc.) and ensuring excellent pain control, reducing peri-operative consumption of opioids and their side effects, and improving patient satisfaction.
Interscalene block (ISB) is the gold stander anesthetic technique for shoulder surgeries but hemi-diaphragmatic paralysis still problematic. The SHAC is the combination of two different blocks. The first block is the inter fascial space between the deep layer of the deltoid fascia and the superficial layer of the subscapularis fascia, anterior to the subscapularis myotendinous junction. This inter fascial space, we can reach both the axillary nerve and the subscapular nerves, the lateral pectoral nerve, and the musculocutaneous nerve results in achieving adequate anesthesia and analgesia without phrenic nerve affection.
The present study will be conducted to compare of SHAC block combined with suprascapular nerve block and Interscalene block as an anesthetic option in shoulder arthroscopic surgery may allow adequate postoperative analgesia and decrease the overall opioid usage and enhanced patient recovery
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Written informed consent from patients.
- •BMI less than or equal 30 kgm .
- •Age 18-75 years old.
- •ASA class I, II and III.
排除标准
- •Allergy to local anesthetics.
- •Infection at site of injection.
- •Patients with coagulopathy.
- •Physical and mental disease which could interfere with pain scores evaluation.
- •pre-existing neuropathy of the operative limb.
- •Pre-existing sever pulmonary diseases (obstructive or restrictive).
- •Patients with distorted local anatomy.
- •Patients with chronic pain syndrom
研究组 & 干预措施
Group SHAC block
Group SHAC block: Patients will receive Ultrasound Guided Shoulder Anterior Capsule block and Suprascapular nerve block
干预措施: Shoulder anterior capsule nerve block (Procedure)
Group IS block
Group IS block: Patients will receive Ultrasound Guided interscalene brachial plexus block.
干预措施: Interscalene Nerve Block (Procedure)
结局指标
主要结局
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by using Visual Analogue Scale (VAS)
时间窗: From start of surgery and for the 1st 24 hours postoperatively.
Inter-operative VAS immediately after the block and every 5 minutes for 30 minutes and every 2 hours post-operatively for 24 hours while 0 indicates no pain and 10 the severest pain.
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by duration of analgesia
时间窗: 24 hours postoperatively
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by duration of analgesia. Duration of postoperative analgesia (from the time of patient recovery till the time of rescue analgesia).
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by amount of opioid consumption postoperatively.
时间窗: 1st 24 hours postoperatively.
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by amount of opioid consumption postoperatively. Total dose of morphine per mg used during the 1st 24 hours postoperatively.
次要结局
- Safety of SHAC block by monitoring of complications eg. local anesthetic toxicity , hemodynamics instability, phrenic nerve affection, pneumothorax.(From start of surgery and for the 1st 24 hours.)
- Patient satisfaction with the anesthesia and analgesia during and after surgery(From start of surgery and for the 1st 24 hours postoperatively.)