Clinical Efficacy of Supraclavicular Block for Arthroscopic Shoulder Surgery

Study Overview
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Brief Summary
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The aim of this study is to compare the efficacy of supraclavicular and interscalene brachial plexus blocks in the patients undergoing arthroscopic shoulder surgery.

Detailed Description
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This study aims to compare supraclavicular brachial plexus block to interscalene brachial plexus block with regard to degree of sensory and motor blockades, side effects and complications of the blocks, and frequency of intraoperative analgesics or antihypertensives use.

Official Title
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Comparison Between Ultrasound-guided Supraclavicular and Interscalene Brachial Plexus Blocks in the Patients Undergoing Arthroscopic Shoulder Surgery

Conditions
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Horner's Syndrome

Intervention / Treatment
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* Other: Supraclavicular block
* Other: Interscalene block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists physical status I-II Body mass index < 35 kg/m2 Exclusion Criteria: Neurologic deficits on the side to be blocked Infection or inflammation at the puncture site for brachial plexus block Psychiatric disorders Patient refusal Difficulty to communicate Coagulation deficiencies

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Interscalene block<br>Interscalene block is performed under ultrasound guidance. Linear probe is placed on the ipsilateral interscalene groove visualizing the brachial plexus located between anterior and middle scalene muscles. Using in-plane technique, nerve stimulation needle is advanced into the brachial plexus sheath, into which 25 ml of 1.5% mepivacaine is injected. | Other: Interscalene block<br>* Redirection of the needle is allowed when spread of local anesthetics does not surround the brachial plexus appropriately and involuntary movement of the forearm or hand is not necessary to confirm the correct placement of the needle.<br>|
| Experimental: Supraclavicular block<br>Supraclavicular block is performed under ultrasound guidance. Linear probe is placed on the ipsilateral supraclavicular fossa visualizing the brachial plexus located lateral to the subclavian artery. Using in-plane technique, nerve stimulation needle is advanced into the brachial plexus sheath, into which 25 ml of 1.5% mepivacaine is injected. | Other: Supraclavicular block<br>* Redirection of the needle is allowed when spread of local anesthetics does not surround the brachial plexus appropriately and involuntary movement of the forearm or hand is not necessary to confirm the correct placement of the needle.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of sensory blockade | Sensory blockade of the C5 to T1 dermatomes was assessed by rating the absence of cold sensation between 100 (intact sensation) and 0 (no sensation) with an alcohol swab. | 20 minutes after the end of local anesthetics injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of motor blockade | Motor blockade was evaluated by elbow and wrist extension (radial nerve), finger abduction (ulnar nerve), wrist flexion (median nerve), and elbow flexion (musculocutaneous nerve). The muscle force was rated on a scale of 0 to 6 as follows (6: normal muscle force; 5: slightly reduced muscle force; 4: greatly reduced muscle force; 3: slightly impaired mobility; 2: greatly impaired mobility; 1: near complete paralysis; 0: complete paralysis). | 20 minutes after the end of local anethetics injection | 
| Side effects | Horner's syndrome (ptosis, miosis, anhidrosis) Subjective dyspnea Hoarseness | 20 minutes after the end of local anethetics injection | 
| Frequency of intraoperative analgesics or antihypertensives use | Frequency of intraoperative use of opioids (fentanyl) or antihypertensives (hydralazine) | At the end of the surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Supraclavicular brachial plexus block, Interscalene brachial plexus block, Arthroscopic shoulder surgery