Efficacy of the 8th Cervical Nerve Root Block During Interscalene Brachial Plexus Block for Arthroscopic Shoulder Surgery: Prospective Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 74
- 试验地点
- 1
- 主要终点
- Pain intensity upon the introduction of a posterior portal
研究概览
简要总结
This study evaluates the effects of selective 8th cervical nerve root block during interscalene brachial plexus block on the relief of pain intensity upon the introduction of a posterior portal during arthroscopic shoulder surgery. The 5th to 7th cervical nerve roots will be blocked in half of participants, while the 5th to 8th cervical nerve roots will be blocked in the other half.
详细描述
By blocking only the 5th to 7th cervical nerve blocks, conventional interscalene brachial plexus block spares the 8th cervical and 1st thoracic dermatomes which innervate the posterior aspect of the shoulder. To visualize the shoulder joint space during shoulder arthroscopic surgery, the introduction of a posterior portal is essential. However, conventional interscalene brachial plexus block cannot effectively relieve the pain caused by its insertion due to sparing of the 8th cervical and 1st thoracic dermatomes. The addition of the 8th cervical nerve root block to conventional interscalene brachial plexus block decreases pain intensity upon the introduction of a posterior portal.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •American Society of Anesthesiologists physical status 1 and 2
- •Arthroscopic shoulder surgery under interscalene brachial plexus block
排除标准
- •Patient refusal
- •Contralateral hemidiaphragmatic paralysis or paresis
- •Contralateral vocal cord palsy
- •Severe pulmonary restrictive disease
- •Coagulopathy
- •Allergy to local anesthetics or history of allergic shock
- •Difficulty communicating with medical personnel
- •Peripheral neuropathy or neurologic sequelae on the operative limb
研究组 & 干预措施
Interscalene block with C8 root block
The 5th to 8th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine
干预措施: Interscalene block with C8 root block (Procedure)
Interscalene block with C8 root block
The 5th to 8th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine
干预措施: 0.75% ropivacaine (Drug)
Conventional interscalene block
The 5th to 7th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine
干预措施: Conventional interscalene block (Procedure)
Conventional interscalene block
The 5th to 7th cervical nerve root block under ultrasound guidance using 25 to 30 ml of 0.75% ropivacaine
干预措施: 0.75% ropivacaine (Drug)
结局指标
主要结局
Pain intensity upon the introduction of a posterior portal
时间窗: 50 minutes after interscalene block
0, 1, and 2 represent no pain, mild pain, and severe pain, respectively.
次要结局
- Frequency of postoperative analgesic use(24 hours)
- Motor blockade(30 minutes after interscalene block)
- Pulmonary function test(Before interscalene block and 30 minutes after interscalene block)
- Complications related with interscalene block(24 hours)
- Postoperative hour when pain starts to be felt(24 hours)
- Patient's satisfaction about surgical anesthesia and postoperative analgesia(24 hours)
- Sensory blockade(30 minutes after interscalene block)
- Ipsilateral hemidiaphragmatic blockade(Before interscalene block and 30 minutes after interscalene block)
- Horner's syndrome(Before interscalene block and 30 minutes after interscalene block)
- Dose of postoperative analgesic use(24 hours)
- Conversion into general anesthesia(1 hour)
- Numerical pain rating score between 6 and 12 hours after surgery(6 and 12 hours)
- Worst numerical pain rating score(24 hours)
- Dose of intraoperative analgesic use(2 hours)
- Numerical pain rating score at admission to postanesthetic care unit(5 minutes)
- Numerical pain rating score at discharge from postanesthetic care unit(30 minutes)
- Numerical pain rating score 24 hours after surgery(24 hours)
- Frequency of intraoperative analgesic use(2 hours)
研究者
JongHae Kim
Associate Professor
Daegu Catholic University Medical Center