Suprascapular Nerve Block Efficacy for Shoulder Surgery

Study Overview
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Brief Summary
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This study evaluates the analgesia induced by suprascapular nerve block in comparison to interscalene nerve block in arthroscopic rotator cuff repairs. The experimental and the control group will receive the suprascapular nerve block and interscalene nerve block, respectively.

Detailed Description
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Peripheral nerve blocks are widely used for postsurgical analgesia. Interscalene nerve block provides a total brachial plexus motor and sensitive blockade while the suprascapular nerve block produces only a specific peripheral blockade. The interscalene nerve block is the most frequently used anesthesia technique and requires a longer learning curve. Complications related to this technique may be more severe and frequent in comparison to other regional anesthesia techniques. The suprascapular nerve block yields less adverse effects, discomfort and rebound effect as this technique does not completely block the upper limb motor function.

Official Title
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Suprascapular Nerve Block Efficacy for Arthroscopic Rotator Cuff Repair: a Randomized Clinical Trial

Conditions
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Shoulder Pain, Postoperative Pain, Rotator Cuff Tears, Anesthesia, Anesthesia, Local

Intervention / Treatment
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* Procedure: Suprascapular nerve block
* Procedure: Interscalene Nerve Block
* Procedure: Arthroscopic rotator cuff repair


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 80 years old Confirmed rotator cuff tear by magnetic resonance imaging Exclusion Criteria: Irreparable cuff tears (retracted lesions to the glenoid rim and/or fourth grade fatty infiltration) Partial repair of cuff tears (immobile lesions) Rheumatic diseases Neck-related shoulder pain Glenohumeral instability or osteoarthritis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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
Interventional Model Description: 2 groups of patients. Randomization into groups SSNB or ISB as per randomization list, for a total of 98 patients
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Suprascapular nerve block (SSNB)<br>Single shot using the blind block technique with 10 ml 0.75% ropivacaine and arthroscopic portals infiltration with 5 ml 0.75% diluted in 15 ml of distilled water. | Procedure: Suprascapular nerve block<br>* The patient lies supine in beach chair position with surgical drapes on. The anatomical landmarks are outlined and the infiltration spot is identified. The block is performed with 10 ml ropivacaine 0.75%.<br>Procedure: Arthroscopic rotator cuff repair<br>* Conventional arthroscopic rotator cuff repair.<br>|
| Active Comparator: Interscalene Nerve Block (ISB)<br>Single shot using US-guided interscalene brachial plexus block with 15 ml 0.5% ropivacaine and arthroscopic portals infiltration with 5 ml 0.75% diluted in 15 ml of distilled water. | Procedure: Interscalene Nerve Block<br>* The patient lies supine position with the head turned to the contralateral side to the block. A linear high-frequency ultrasound probe is used for identifying the roots of supraclavicular brachial plexus using the traceback technique. The block is performed with 15 ml ropivacaine 0.5%.<br>* Other names: Interscalene Brachial Plexus Nerve Blockade;Procedure: Arthroscopic rotator cuff repair<br>* Conventional arthroscopic rotator cuff repair.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity: Numeric Pain Rating Scale | Numeric Pain Rating Scale - no pain (0), unbearable pain (10) | 1 hour after surgery | 
| Pain intensity: Numeric Pain Rating Scale | Numeric Pain Rating Scale - no pain (0), unbearable pain (10) | 24 hours after surgery | 
| Pain intensity: Numeric Pain Rating Scale | Numeric Pain Rating Scale - no pain (0), unbearable pain (10) | 48 hours after surgery | 
| Pain intensity: Numeric Pain Rating Scale | Numeric Pain Rating Scale - no pain (0), unbearable pain (10) | 72 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opiate Consumption | Total amount of narcotics consumed during the postoperative period measured in morphine equivalents (OME). | Postoperative hours 1-72 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anesthesia, Opioid, Shoulder surgery, Pain, Brachial plexus blockage, Interscalene blockage