Supraclavicular Versus Interscalene Block for Shoulder Surgery

Study Overview
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Brief Summary
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The purpose of this study is to compare the supraclavicular block to interscalene block in patients undergoing arthroscopic shoulder surgery.

Detailed Description
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The aim of this study is to evaluate the efficacy of the supraclavicular block in comparison with interscalene block on postoperative pain, quality of recovery and side effects in patients undergoing arthroscopic shoulder surgery under general anesthesia.

Official Title
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A Prospective Randomized Comparison of Ultrasound-guided Supraclavicular and Interscalene Block in Patients Undergoing Arthroscopic Shoulder Surgery

Conditions
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Pain

Intervention / Treatment
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* Procedure: Supraclavicular Block
* Procedure: Interscalene Block
* Drug: Bupivacaine
* Device: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing shoulder surgery in American Society of Anesthesiologists physical status I-II Exclusion Criteria: with a known allergy to study medications, chronic opioid use, ipsilateral upper limb neurological deficits, severe respiratory disease, coagulopathy

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
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Supraclavicular Block<br>Ultrasound guided supraclavicular block with 20 ml of 0.25% bupivacaine will be performed | Procedure: Supraclavicular Block<br>* Under ultrasound guidance an insulated needle is advanced with in- plane technique into the brachial plexus sheath and 20ml 0.25% bupivacaine will be administered<br>Drug: Bupivacaine<br>* 20ml 0.25% bupivacaine will be injected for brachial plexus block<br>* Other names: Marcaine;Device: Ultrasound<br>* The Ultrasound will be used for brachial plexus visualization<br>|
| Active Comparator: Interscalene block<br>Ultrasound guided inter scalene block with 20ml of 0.25% bupivacaine will be performed. | Procedure: Interscalene Block<br>* Under ultrasound guidance an insulated needle will be placed through the middle scalene muscle,into the interscalene groove with in-plane technique and 20ml 0.25%bupivacaine will be administered into the brachial plexus<br>Drug: Bupivacaine<br>* 20ml 0.25% bupivacaine will be injected for brachial plexus block<br>* Other names: Marcaine;Device: Ultrasound<br>* The Ultrasound will be used for brachial plexus visualization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative Pain | The visual analog scale will be used for assessment | up to postoperative 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of recovery | The Quality of Recovery-40 (QR40) questionnaire will be used for assessment | in the postoperative 24 hours | 
| Motor block | The muscle force will be evaluated with scale 0 to 3( 0:normal muscle force, 1: reduced muscle force, 2: impaired mobility 3: paralysis | up to postoperative 24 hours | 
| Sensory block | The sensorial block will be assessed by pinprick test. | up to postoperative 24 hours | 
| Adverse events | The number of patients with adverse events will be recorded. | up to postoperative 24 hours | 
| Analgesics requirement time | the first intravenous analgesic requirement time will be recorded. | up to postoperative 24 hours | 
| Systolic Blood pressure changes | The blood pressure will be measured non invasively and the systolic blood pressure lower than 90 mmHg or decrease more than 20% of baseline will be accepted as a hypotension. | at time of surgery | 
| Heart rate changes | The heart rate will be assessed via electrocardiographic monitoring and recorded as beat/minute. | at time of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain, Anesthesia Recovery Period, Brachial Plexus