Sub Omohyoid Suprascapular Nerve Block Versus Interscalene Nerve Block

Study Overview
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Brief Summary
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Shoulder surgery can be very painful surgery after which the use of opioids is often required. The well-known side-effects of opioids (e.g. respiratory depression, somnolence, nausea, vomiting, and pruritus) limit their use in so called 'fast track' surgery and anaesthesia programmes. the study aimed to compare the effect of sub omohyoid suprascapular nerve block versus interscalene nerve block in preventing postoperative pain and decreasing analgesic consumption in patients scheduled for shoulder surgery

Official Title
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Sub Omohyoid Suprascapular Nerve Block Versus Interscalene Nerve Block for Postoperative Shoulder Surgery Pain: Randomized Comparative Study.

Conditions
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Post Operative Pain, Regional Anesthesia, Nerve Block

Intervention / Treatment
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* Procedure: subomohyoid plane block
* Procedure: Interscalene brachial plexus block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18-60 years. ASA I-II. Both sexes. Shoulder surgery. Exclusion Criteria: Patient refusal Allergy to local anesthetics BMI >40 kg/m2 Bleeding diathesis or history of anticoagulant use. Psychiatric diseases. Infection of the skin at the site of needle punctures area.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: subomohyoid suprascapular nerve<br>superficial probe of ultrasound was placed in the transverse plane to visualize the superior trunk in the short axis. The suprascapular nerve was identified as it branched off from the superior trunk and traced until it coursed beneath the inferior belly of the omohyoid muscle. | Procedure: subomohyoid plane block<br>* The block needle was inserted in line with the probe in a lateral-to-medial orientation toward the suprascapular nerve. Local anesthetic solution was then injected after negative aspiration for blood to achieve circumferential spread around the neurovascular bundle<br>|
| Active Comparator: Interscalene brachial plexus<br>ultrasound-guided interscalene block involves imaging the C5 and C6 roots at approximately the level of the cricoid cartilage, just distal to where they emerge from behind their respective transverse processes and where they lie in the groove between the anterior and middle scalene muscles | Procedure: Interscalene brachial plexus block<br>* The block needle is usually advanced in plane in a lateral-to-medial direction through the middle scalene muscle to contact the nerve roots and inject local anesthetic around them.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue pain score | pain score from 0 to 10 which mean 0 no pain and 10 the worst pain ever | 24 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time of first analgesic request | the time of first demand rescue analgesia | 24 hour | 
| Total analgesic consumption | total fentanyl demand | 24 hour | 
| Incidence of any side effects | oxygen desaturation, pneumothorax, dyspnea, and phrenic nerve palsy, block, and opioid-related side effects | 24 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Interscalene brachial plexus block, shoulder pain, subomohyoid plane block