Interscalene Block Alone Versus Interscalene Block With Erector Spinae Plane Block for Shoulder Arthroscopy Anesthesia

Study Overview
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Brief Summary
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The aim of this study is to compare the effectiveness of interscalene brachial plexus block alone versus interscalene brachial plexus block +Erector spinae plane block in anesthesia for shoulder arthroscopy.

Detailed Description
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Regional anesthetic techniques can control pain effectively, both at rest and on movement, allowing earlier mobilization without the adverse effects of opioids . Among the various types of regional anesthetic techniques, the interscalene brachial plexus block is a gold standard used nerve block technique for postoperative analgesia in patients undergoing shoulder surgery, as it has consistently been shown to significantly control.

Official Title
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Interscalene Block Alone Versus Interscalene Block With Erector Spinae Plane Block for Shoulder Arthroscopy Anesthesia: A Randomized Controlled Trial

Conditions
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Randomized Controlled Trial, Interscalene Block, Erector Spinae Plane Block, Shoulder Arthroscopy Anesthesia

Intervention / Treatment
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* Other: interscalene with Erector spinae plane block group
* Other: Interscalene group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18-65 years Both genders, BMI < 40 kg/m2 American Society of Anesthesiologists (ASA) physical status I-II Scheduled for elective shoulder arthroscopy. Exclusion Criteria: Known allergy to local anesthetics, allergy to all opioid medications, diagnostic shoulder arthroscopic procedures, patients with chronic opioids, patients who converted to general anesthesia use and coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Interscalene with erector spinae plane block group<br>Patients will receive interscalene brachial plexus block using 10 ml of bupivacaine 0.5% and ultrasound guided erector spinae plane block at thoracic (T2) using 10 ml of bupivacaine 0.5%. | Other: interscalene with Erector spinae plane block group<br>* patients will receive interscalene brachial plexus block using 10 ml of bupivacaine 0.5% and US guided Erector spinae plane block at T2 using 10 ml of bupivacaine 0.5%.<br>|
| Experimental: Interscalene group<br>Patients will receive interscalene brachial plexus block using 15 ml of bupivacaine 0.5%. | Other: Interscalene group<br>* patients will receive interscalene brachial plexus block using 15 ml of bupivacaine 0.5%.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraoperative fentanyl consumption | If the patient complains of pain during surgery, fentanyl will be administered 1 µg/kg IV increments. | Intraoperative up to 4 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Amount of 24hrs postoperative rescue analgesic consumption | Intravenous meperidine (0.5 mg/kg) will be administered if numerical pain rating scale (NRS) score of more than 3. | 24 hours postoperatively | 
| Degree of pain by Numerical pain rating scale | Postoperative pain (using NRS at admission) will be measured at PACU, 1h, 2hr. 4hr, 6hr, 8hr, 12hr, 18hr, and 24hrs postoperative. NRS (0 represents no pain while 10 represents the worst pain imaginable). | 24 hours postoperatively | 
| Time to first request of rescue analgesia. | Rescue analgesia in the form of IV meperidine (0.5 mg/kg) boluses if NRS >3. Time to the 1st rescue analgesic request will be recorded. | 24 hours postoperatively |