Interscalene and Combined Supra Scapular and Axillary Nerve Blocks in Rotator Cuff Repair

Study Overview
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Brief Summary
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Primary objective of this study is to prospectively compare and evaluate efficacy as well as note side effects of the interscalene block and combined suprascapular and axillary nerve block for ambulatory arthroscopic rotator cuff repair.

Detailed Description
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Patients having elective arthroscopic rotator cuff repair will be randomized to one of the two groups. Group 1: This group will receive Interscalene block (ultrasound guided and nerve stimulator aided) followed by a general anesthesia. Group 2: This group will receive Suprascapular and Axillary nerve block (ultrasound guided and nerve stimulator aided) followed by a general anesthesia. Performance time, quality and efficacy as well as any side-effects of the blocks will be evaluated in terms of pain scores in recovery room, after 4- 6 hours and the next morning, opioid usage and patient satisfaction. Primary hypothesis: • Combined Suprascapular and axillary nerve blocks provide similar postoperative analgesia as compared to interscalene block for arthroscopic rotator cuff repair. Secondary hypothesis • Interscalene block is associated with more side effects and complications as compared to suprascapular nerve block and axillary nerve block.

Official Title
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A Randomized Comparison of Inter Scalene and Combined Supra Scapular and Axillary Nerve Blocks for Postoperative Pain Relief in Arthroscopic Shoulder Rotator Cuff Repair

Conditions
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Disorder of Rotator Cuff

Intervention / Treatment
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* Procedure: interscalene block
* Procedure: Suprascapular and Axillary nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective shoulder arthroscopic rotator cuff repair ASA I - III (American Society of Anaesthesia Classification) Exclusion Criteria: ASA IV or higher ( American Society of Anaesthesia Classification) Obesity: BMI >35 Narcotic Abuse/ Drug dependency Major Neurologic deficits Allergy to local anesthetics Infection in the site of the puncture Mental impairment

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Interscalene block<br>This arm patients will receive inter scalene block which will be ultrasound and nerve stimulator guided. | Procedure: interscalene block<br>* This arm patients will receive inter scalene block which will be ultrasound and nerve stimulator guided.<br>|
| Active Comparator: Suprascapular and Axillary nerve block<br>This arm patients will receive Suprascapular and axillary nerve blocks which will be ultrasound guided and nerve stimulator guided. | Procedure: Suprascapular and Axillary nerve block<br>* This arm patients will receive Suprascapular and axillary nerve blocks which will be ultrasound guided and nerve stimulator guided.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Analgesic Efficacy | Visual Analogue scores for pain will be analyzed using chi-squared test. Interscalene block (ISB) of the brachial plexus has been demonstrated to be one of the most effective analgesic modality during arthroscopic shoulder surgery. However, despite its (ISB) time-tested record of relative safety, ISB is associated with some complications. These could be central nervous system, respiratory and cardiovascular complications. These side effects and complications are based upon the anatomy of the brachial plexus at this level.Recently, suprascapular and axillary nerve blocks have been used to control postoperative shoulder pain. The study will try to find out whether combined supra scapular and axillary nerve blocks are as effective in pain control as compared to inter scalene block. | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Side effects | The study will try to find out whether combined supra scapular and axillary nerve blocks are associated with less side effects as compared to inter scalene block. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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interscalene, suprascapular, axillary