Supraclavicular Versus Interscalene Block

Study Overview
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Brief Summary
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We hypothesize that both ultrasound-guided supraclavicular and interscalene block provide similar analgesia after shoulder surgery.

Detailed Description
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Interscalene block provides effective postoperative analgesia after shoulder surgery. However, it can be associated with significant risk including the phrenic nerve palsy. Previous study reported that ultrasound-guided interscalene and supraclavicular blocks are effective and safe for shoulder arthroscopy.

Official Title
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A Randomized Comparison of Ultrasound-guided Supraclavicular and Interscalene Block After Shoulder Surgery

Conditions
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Pain

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


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists physical status I-III inpatients undergoing shoulder surgery Exclusion Criteria: pregnancy, severe respiratory disease, preexisting neuropathy in the operated arm, coagulopathy, allergy to study medication

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: Quadruple


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, an insulated needle is advanced into the brachial plexus sheath, into which 20 ml of 0.375% ropivacaine is injected. | Procedure: Interscalene block<br>* Ultrasound-guided interscalene block is performed.<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, an insulated needle is advanced into the brachial plexus sheath, into which 20 ml of 0.375% ropivacaine is injected. | Procedure: Supraclavicular block<br>* Ultrasound-guided supraclavicular block is performed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain duration |  | at 24h after operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| diaphragmatic movement |  | preoperative, after block(at 30 min), after operation | 
| motor block |  | after block(at 30 min), after operation, at 24h | 
| paresthesia |  | after block(at 30min), after operation, at 24h | 
| complications |  | after block (at 30 min), after operation, at 24h | 
| supplemental analgesia |  | after operation, at 24h | 
| pain score |  | at 24h | 
| patient satisfaction |  | at 24h |