Interscalene Block Versus Erector Spinae Plane Block for Shoulder Arthroscopy Anesthesia

Study Overview
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Brief Summary
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The aim of this study is to compare the effectiveness of ESPB versus ISB in anesthesia for shoulder arthroscopy

Detailed Description
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Regional anesthetic techniques can control pain effectively, both at rest and on movement, allowing earlier mobilization without the adverse effects of opioids. Among the various types of regional anesthetic techniques, the interscalene brachial plexus block (ISB) is a gold standard used nerve block technique for postoperative analgesia in patients undergoing shoulder surgery, as it has consistently been shown to significantly control. the interscalene brachial plexus block (ISB) regional anesthesia offers many advantages over general anesthesia for both arthroscopic and open surgeries of the shoulder it provides excellent intraoperative anesthesia and muscle relaxation' as well as analgesia that continues into the postoperative period

Official Title
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Interscalene Block Versus Erector Spinae Plane Block for Shoulder Arthroscopy Anesthesia: A Randomized Controlled Trial

Conditions
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Interscalene Block, Erector Spinae Plane Block, Arthroscopy

Intervention / Treatment
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* Procedure: Erector spinae plane block
* Procedure: Interscalene brachial plexus block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with Body Mass Index < 40 kg/m2 American Society of Anesthesiologists (ASA) physical status I-II scheduled for elective shoulder arthroscopy Exclusion Criteria: Known allergy to local anesthetics Allergy to all opioid medications Diagnostic shoulder arthroscopic procedures Patients with chronic opioids Patients who converted to general anesthesia use and coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Erector spinae plane block group<br>3ml lidocaine 2% will be used to anesthetize the skin. Using a 20-gauge block needle put in-plane in a cephalad-to-caudad orientation to position the tip into the fascial plane on the deep (anterior) side of the erector spinae muscle, 20 ml bupivacaine 0.5% will be injected. | Procedure: Erector spinae plane block<br>* Using a 20-gauge block needle put in-plane in a cephalad-to-caudad orientation to position the tip into the fascial plane on the deep (anterior) side of the erector spinae muscle, 20 ml bupivacaine 0.5% will be injected<br>|
| Active Comparator: Interscalene group<br>Using a lateral-to-medial approach, the 25-gauge needle will be inserted into the middle scalene muscle, advanced, and placed immediately lateral to the nerve roots. the needle will be visualize using an ultrasound beam to avoid intraneural and intravascular injections. After confirming negative blood aspiration, we will inject 15 mL of 0.5% bupivacaine around the nerve roots | Procedure: Interscalene brachial plexus block<br>* Using a lateral-to-medial approach, the 25-gauge needle will be inserted into the middle scalene muscle, advanced, and placed immediately lateral to the nerve roots. the needle will be visualize using an ultrasound beam to avoid intraneural and intravascular injections. After confirming negative blood aspiration, we will inject 15 mL of 0.5% bupivacaine around the nerve roots<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraoperative fentanyl consumption | Fntanyl will be administered 1 µg/kg IV increments. | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain | numeric rating scale (NRS) (0 represents no pain while 10 represents the worst pain imaginable). | 24 hours postoperative | 
| Rescue analgesia in the form of IV meperidine (0.5 mg/kg) boluses if NRS >3. Time to the 1st rescue analgesic request will be recorded |  | 24 hours postoperative | 
| Total amount of rescue analgesic | Rescue analgesia in the form of IV meperidine (0.5 mg/kg) boluses if NRS >3. | 24 hours postoperative |