Pain Management in Arthtroscopic Shoulder Surgery

Study Overview
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Brief Summary
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It is compared that combined suprascapular and infraclavicular nerve blocks to interscalene nerve block for clinical outcomes after shoulder surgery

Detailed Description
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In this study, the investigators planned to investigate postoperative pain, analgesic dosage, respiratory effects of the block and side effects of patients undergoing general anaesthesia after arthroscopic shoulder surgery under preoperative interscalene nerve block or suprascapular + infraclavicular nerve block.

Official Title
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Comparison of the Effects Combined Suprascapular and Infraclavicular Nerve Blocks to Interscalene Nerve Block Applied Arthtroscopic Shoulder Surgery

Conditions
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Arthroscopic Shoulder Surgery

Intervention / Treatment
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* Other: Interscalene block
* Other: suprascapular and infraclavicular nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for elective shoulder surgery under general anesthesia with suprascapular + infraclavicular nerve block or interscalene nerve block for any reason ASA 1-3 patients Exclusion Criteria: Diabetes coagulopathy local anesthetic allergy chronic opioid users neurological deficit of the surgical limb obstructive or restrictive pulmoner disease inability to understand pain scores

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Interscalene nerve block<br>preoperative interscalene nerve block to be applied with ultrasound guidance. | Other: Interscalene block<br>* 30 minutes before anaesthesia induction interscalene nerve block will be applied with ultrasound guidance with %0,25 bupivacain 20 cc .The sham block consisted of after patients were placed in the lateral decubitus position skin preparation, ultrasound scanning of the suprascapular region, and a dry-needling, all performed to preserve patient blinding in the ISB group patients.<br>|
| Active Comparator: suprascapular and infraclavicular nerve block<br>preoperative suprascapular and infraclavicular nerve block to be with ultrasound guidance | Other: suprascapular and infraclavicular nerve block<br>* 30 minutes before anaesthesia induction suprascapular with %0,25 bupivacain 10 cc .and infraclavicular nerve block with %0,25 bupivacain 10 cc will be applied with ultrasound guidance<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative pain: numeric rating scale (NRS) | postoperative pain will be evaluated by numeric rating scale (NRS) . | postoperative 30. minute, 4. hour, 8.hour,12. hour, 24. hour, 48. hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| phrenic nerve paralysis evaluated with ultrasound | Thirty minutes after the block, M-mode ultrasound examination of the ipsilateral hemidiaphragm was performed to measure diaphragmatic excursion. | thirty minutes after the nerve block |