Efficacy of Erector Spinae Plane Block Versus Infraclavicular Subomohyoid Block in Shoulder Surgery

Study Overview
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Brief Summary
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The study aimed to compare Erector Spinae Plane (ESP) block versus infraclavicular subomohyoid (ISO) block in the provision of efficacy of either technique in postoperative analgesia in shoulder surgery, aiming to testing the safety of each block in terms of incidence of complications. Patients will be randomly divided into two groups, Group E will receive Erector spinae block and group I will receive infraclavicular subomohyioid block. The local anesthetic solution that will be used in both blocks will be a total volume of 30 mls 0.25%bupivacaine plus 3mg preservative free Dexamethasone. The time between recovery from anesthesia and first pain experienced, as verified by NRS ≥ 3 and first need of a rescue analgesic, will be defined as the duration of analgesia. The total dose of intravenous morphine (the rescue analgesic) used over 24 h postoperatively will be recorded.

Official Title
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Efficacy of Erector Spinae Plane Block Versus Infraclavicular Subomohyoid Block in Shoulder Surgery: A Randomized Controlled Blinded Study

Conditions
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Postoperative Pain, Shoulder Pain

Intervention / Treatment
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* Procedure: Erector spinae block
* Procedure: Infraclavicular subomohyoid (ISO) block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients, above 18 years old. ASA physical status I Scheduled for shoulder surgery Exclusion Criteria: Morbid obese. Previous surgery in the same shoulder. History of psychiatric disorder. Pulmonary disease. Contraindication to regional nerve block (e.g. skin infection at the puncture site, coagulopathy). Allergy to any of medications that will be used

Ages Eligible for Study
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Minimum Age: 18 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Erector spinae block<br>Ultrasound guidance will be used to visualize the transverse processes of T2 and the overlying muscles. Under sterile conditions, a 5-cm, 21-gauge needle will be inserted using the out-of-plane technique parallel to the sagittal plane directly over the transverse process,then 30mL of the local anesthetic solution will be injected and observed for the linear spread of LA the under direct ultrasound visualization | Procedure: Erector spinae block<br>* A 5-cm needle prick in the back of the patient 3 cm lateral to mid-line under sterile conditions, with ultrasound guidance.<br>|
| Active Comparator: infraclavicular subomohyoid block<br>Performing posterior approach infraclavicular BP block followed by subomohioid block via the same puncture site under ultrasound guidance. | Procedure: Infraclavicular subomohyoid (ISO) block<br>* Under complete aseptic precaution, 12 cm needle will be inserted 2cm superior to the clavicle and advanced retroclavicular, with ultrasound guidance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The block efficacy | Percentage of 24 hours pain free patients | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The incidence of expected complications ( Block safety) | The incidence of expected complications such as phrenic nerve palsy or pneumothorax. | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Erector Spinae Plane Block, Infraclavicular Subomohyoid Block, Shoulder Surgery