Pain Control After Arthroscopic Shoulder Surgeries

Study Overview
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Brief Summary
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This study will be conducted to compare the perioperative analgesic efficacy of ultrasound - guided interscalene brachial plexus block versus combined shoulder anterior capsular block and anterior suprascapular nerve block for arthroscopic shoulder surgeries.

Official Title
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Comparative Study of Analgesic Efficacy of Ultrasound Guided Interscalene Block Versus Combined Shoulder Anterior Capsular Block and Suprascapular Nerve Block for Arthroscopic Shoulder Surgeries.

Conditions
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Post Operative Pain

Intervention / Treatment
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* Procedure: Ultrasound-guided Interscalene Block group
* Procedure: Combined Ultrasound guided shoulder anterior capsular block and suprascapular nerve block
* Drug: Bupivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged 20-65 years of both sexes, with American Society of Anesthesiologists (ASA) physical status I or II admitted for arthroscopic shoulder surgery. Exclusion Criteria: Patient refusal. Uncooperative patient. Patient with neurological deficit. Patients with respiratory disorders. Patient with bleeding disorders. Infection at the block injection site. Patients with history of allergy to local anesthetics.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 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 |
| --- | --- |
| Active Comparator: group 1 Ultrasound-guided Interscalene Block group<br>In this group, ultrasound-guided ISB will be done using 10 ml of bupivacaine 0.25%. | Procedure: Ultrasound-guided Interscalene Block group<br>* ultrasound guided interscalene block versus combined ultrasound guided shoulder anterior capsular block and suprascapular nerve block for arthroscopic shoulder surgery<br>Drug: Bupivacaine<br>* bupivacaine 0.25%.<br>|
| Active Comparator: group 2 Combined Ultrasound guided shoulder anterior capsular block and suprascapular nerve block<br>, ultrasound-guided SHAC block will be done using 10 ml of bupivacaine 0.25% injected in the interfacial plane between deltoid and subscapular muscle and 10 ml of bupivacaine 0.25% injected in the pericapsular space. Ultrasound-guided SSN block will be done using 10 ml of bupivacaine 0.25% injected at sub omohyoid space. | Procedure: Combined Ultrasound guided shoulder anterior capsular block and suprascapular nerve block<br>* Combined Ultrasound guided shoulder anterior capsular block and suprascapular nerve block<br>Drug: Bupivacaine<br>* bupivacaine 0.25%.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post operative analgesic consumption | The first 24 hours post operative analgesic consumption | 24 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue score (VAS) in the first 24 hours after surgery | - Postoperative pain intensity will be assessed in the first 24 hour using VAS score where (0 = no pain and 100 = the worst imaginable pain) | first 24 hours after surgery | 
| Patient satisfaction score | Patient satisfaction score will be assessed on the basis of a questionnaire and graded on a 4-point scale (excellent/good/fair/poor). | first 24 hours after surgery | 
| The incidence of hemi diaphragmatic paralysis | hemidiaphragmatic paralysis after block | immediately before block and immediately after procedure |