is There an Alternative to Ultrasound Guided Interscalene Block?

Study Overview
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Brief Summary
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Interscalene brachial plexus block is the gold standard for perioperative pain management in shoulder surgery. However, this technique would have side effects and potential serious complications. The aim of this study is to compare between the combination of ultrasound guided suprascapular and supraclavicular nerve blocks versus ultrasound guided interscalene brachial plexus block for post operative analgesia after shoulder instability surgery with latarjet procedure.

Official Title
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the Association of Ultrasound Guided Suprascapular and Supraclavicular Nerve Block Provides Adequate Analgesia in Comparison With Ultrasound Guided Interscalene Block

Conditions
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Interscalene Block, Regional Anesthesia, Shoulder Surgery

Intervention / Treatment
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* Drug: bupivacaine
* Device: ultrasound
* Drug: morphine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA physical status I-III 18-75 years of age, inclusive shoulder surgery (LATARJET technique) Exclusion Criteria: contraindications to brachial plexus block (e.g., allergy to local anesthetics, coagulopathy, malignancy or infection in the area) existing neurological deficit pregnancy history of neck surgery or radiotherapy severe respiratory disease inability to understand the informed consent and demands of the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: group BIS<br>scheduled for ultrasound guided interscalene blockade with 30 ml of bupivacaine 0.25% | Drug: bupivacaine<br> <br> Device: ultrasound<br>* ultrasound guided nerve blocks<br>Drug: morphine<br> <br> |
| Experimental: group BS<br>scheduled for selective blockade of the ultrasound guided suprascapular (15 ml bupivacaine 0.25%) and supraclavicular (15 ml bupivacaine 0.25%) nerves blocks | Drug: bupivacaine<br> <br> Device: ultrasound<br>* ultrasound guided nerve blocks<br>Drug: morphine<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogic Scale | quality of postoperative analgesia | until 48 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time to perform the blocks |  | up to 5 minutes | 
| patient satisfaction | scale from 0 (not satisfied at all) to 100 (full satisfaction) | 48 hours post performing nerves blocks | 
| occurrence of complications |  | 48 hours post performing nerves blocks | 
| total dose of morphine consumption in mg |  | during 48 hours post operative |