Evaluation of Supraclavicular, Suprascapular, and Interscalene Nerve Blocks for Outpatient Shoulder Surgery

Study Overview
=================
Brief Summary
-----------------
The aim of this study is to assess analgesic efficacy of a supraclavicular nerve block, suprascapular nerve block, or interscalene nerve block in a population undergoing shoulder arthroscopy with rotator cuff repair. The investigators hypothesize that subjects from all three arms will receive equal analgesia since these blocks are routinely performed to treat post-operative pain after shoulder surgery.

Official Title
-----------------
Evaluation of Supraclavicular, Suprascapular, and Interscalene Nerve Blocks for Outpatient Shoulder Surgery

Conditions
-----------------
Pain, Postoperative, Pain, Shoulder Joint, Pathologic Processes

Intervention / Treatment
-----------------
* Procedure: Brachial plexus nerve block


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Unilateral total shoulder arthroscopy for rotator cuff surgery ASA physical status I-III, >18 years old, Non-pregnant, Consent to participate in the study Exclusion Criteria: Refusal to participate, < 18 years old, Chronic opioid use, Localized infection, Pregnancy or lactating, Pre-existing coagulopathy, Allergy to ultrasound gel or local anesthetics, Diaphragmatic dysfunction

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Interscalene<br>Single-shot Interscalene Nerve Block with ropivacaine 0.5% | Procedure: Brachial plexus nerve block<br>* All arms of the study comparing the three different blocks are receiving the same single injection bolus of ropivacaine 0.5% prior to surgery. We will then record and compare pain scores in PACU and opioid requirement.<br>|
| Active Comparator: Supraclavicular<br>Single-shot Supraclavicular Nerve Block with ropivacaine 0.5% | Procedure: Brachial plexus nerve block<br>* All arms of the study comparing the three different blocks are receiving the same single injection bolus of ropivacaine 0.5% prior to surgery. We will then record and compare pain scores in PACU and opioid requirement.<br>|
| Active Comparator: Suprascapular<br>Single-shot Suprascapular Nerve Block with ropivacaine 0.5% | Procedure: Brachial plexus nerve block<br>* All arms of the study comparing the three different blocks are receiving the same single injection bolus of ropivacaine 0.5% prior to surgery. We will then record and compare pain scores in PACU and opioid requirement.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain | NRS Pain Scale | Same day, 1 hour after arrival in the post-anesthesia care unit after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung function | Vital Capacity, Spirometry | Same day, 1 hour after arrival in the post-anesthesia care unit after surgery | 
| Sensory and Motor Function | Sensory Dermatome assessment C4 - C8 to touch; Motor assessment of grip and biceps with dynamometer | Same day, 1 hour after arrival in the post-anesthesia care unit after surgery | 
| Diaphragmatic excursion | Ultrasound measuring the diaphragm movement in centimeters (cm) | Same day, 1 hour after arrival in the post-anesthesia care unit after surgery |