Clinical trial NCT03212443: Combined Suprascapular and Axillary Nerve Blocks for Arthroscopic Shoulder Surgery
Official title: Combined Suprascapular and Axillary Nerve Blocks for Sevoflurane Consumption and Postoperative Analgesia in Arthroscopic Shoulder Surgery
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Arthroscopic Shoulder Surgery
Suprascapular Nerve Block
Axillary Nerve Block
Lead sponsor: Diskapi Teaching and Research Hospital
Sponsor class: OTHER
First posted: 2017-07-11
Enrollment: 46
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Arthroscopic shoulder surgery is associated with severe pain postoperatively. Regional nerve block adding to general anesthesia might improve the quality of postoperative analgesia. The aim of the study is to compare the subacromial local anesthetic infiltration and the suprascapular-axillary nerve blocks combination for intraoperative sevoflurane consumption, postoperative analgesia and analgesic consumption.

Detailed description: After informed consent and with ethics approval, 60 ASA 2-3 patients scheduled for elective arthroscopic shoulder surgery will be included in this study. Patient will be divided to two groups by using computer -generated list for randomization. In group A, the surgeon will apply 20 ml of 0.250% bupivacaine to the subacromial region at the end of the procedure. In Group B, suprascapular (10 ml of 0.250% bupivacaine ) and axillary block (10 ml of 0.250% bupivacaine) will be performed with ultrasound and nerve stimulator guidance before induction of anesthesia. In all patients after standard and BIS (Bi spectral index) monitorization general anesthesia will be induced with remifentanil (10mcg iv), propofol (2.5 mg/kg iv) and rocuronium (0.5mg/kg iv). After intubation, anesthesia will be maintained with 50% O2 and N2O mixture. Hemodynamic parameters, BIS values, end-tidal sevoflurane consumption will be recorded by blind investigator. Postoperative visual analog scale (VAS) values, postoperative analgesic consumption (Tramadol, patient controlled analgesia), complications will be recorded.

Eligibility criteria: Inclusion Criteria:

* American society of anesthesia physical status (ASA) 1,2 patients
* Elective arthroscopic shoulder surgery

Exclusion Criteria:

* ASA 3,4 patients
* Coagulation abnormality
* Body mass index \>30
* Preexisting neurological deficit Local anesthetic allergy history Diabetes

Primary outcomes:
measure: Postoperative VAS scores
timeFrame: Through postoperative period, an avarage of 30 minutes
Secondary outcomes:
measure: sevoflurane consumption
timeFrame: 5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia
Other outcomes:
measure: Bleeding assesment
timeFrame: 5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia
Locations:
city: Ankara
country: Turkey
facility: Derya Ozkan
Study officials:
affiliation: Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital
name: Derya Ozkan
role: PRINCIPAL_INVESTIGATOR
References:
citation: Dhir S, Sondekoppam RV, Sharma R, Ganapathy S, Athwal GS. A Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery: An Equivalence Study. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):564-71. doi: 10.1097/AAP.0000000000000436.
citation: Ritchie ED, Tong D, Chung F, Norris AM, Miniaci A, Vairavanathan SD. Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality? Anesth Analg. 1997 Jun;84(6):1306-12. doi: 10.1097/00000539-199706000-00024.