A Novel Selective Block of the Suprascapular Nerve

Study Overview
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Brief Summary
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Patients who receive the lateral and sagittal infraclavicular block (LSIB) tend to supinate their hand and forearm which may hamper optimal positioning for surgery of the dorsal side of the hand. The investigators think that this supination is caused by lateral rotation in the shoulder. The main lateral rotator of the shoulder is the infraspinatus muscle, which is innervated by the suprascapular nerve (SSN).The investigators hypothesized that optimal positioning of the hand for surgery on the dorsal side of the hand may be achieved by performing a SSN block (SSNB) in addition to the LSIB.

Detailed Description
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According to the hypothesis the investigators will perform a double blind , placebo controlled study to answer the research question above.

Official Title
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A Novel Selective Block of the Suprascapular Nerve

Conditions
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Ligament Injury, Fracture

Intervention / Treatment
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* Procedure: LSIB + SSNB


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with American Society of Anesthesiologists physical status (ASA) I- III age between 18 and 70 years body mass index between 20 and 36 kg/m2 scheduled for elective hand surgery. Exclusion Criteria: We will measure the angle between wrist and horizontal plane while the patient is supine and the extended arm 75° abducted. Patient who are not able to pronate the hand ≤15° before block performance, will be excluded from the study. Patients will also be excluded if they are pregnant, have contraindications to regional anesthesia, coagulation disorder, allergy to local anesthetics (LA), atrioventricular block, peripheral neuropathy or drug-treated diabetes. Patients using other anticoagulation drugs than acetylsalicylic acids or dipyridamol will be excluded.

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: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: LSIB +SSNB<br>Patients will receive LSIB (31 ml ropivacaine 7.5 mg/ml)+ SSNB (4 ml Ropivacaine 5 mg/ml) | Procedure: LSIB + SSNB<br>* Patients will receive LSIB (31 ml ropivacaine 7.5 mg/ml)+ SSNB (4 ml Ropivacaine 5 mg/ml) or LSIB (31 ml ropivacaine 7.5 mg/ml)+ SSNB (4 ml placebo, saline)<br>|
| Placebo Comparator: LSIB + placebo<br>Patients will receive LSIB (31 ml ropivacaine 7.5 mg/ml) + SSNB (4 ml saline) | Procedure: LSIB + SSNB<br>* Patients will receive LSIB (31 ml ropivacaine 7.5 mg/ml)+ SSNB (4 ml Ropivacaine 5 mg/ml) or LSIB (31 ml ropivacaine 7.5 mg/ml)+ SSNB (4 ml placebo, saline)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wrist angle | The investigators will assess the wrist angle 30 minutes after the two blocks (LSIB + SSNB) | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Satisfaction score | The investigators will ask the surgeons about his/her satisfaction with the hand position during surgery. | 3 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Brachial plexus block, Suprascapular nerve block