Clinical trial NCT04446403: Circumflex Nerve Blocks Versus Posterior Cord Nerve Blocks in Shoulder Arthroscopy
Official title: Analgesic Effect of Ultrasound Guided Combined (Suprascapular and Circumflex Nerve Blocks ) Versus (Suprascapular Nerve and Posterior Cord Nerve Blocks at Infraclavicular Level ) During Shoulder Arthroscopy : A Randomized Controlled Study
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Postoperative Pain
Lead sponsor: Cairo University
Sponsor class: OTHER
Collaborators: name: Cairo University
First posted: 2020-06-24
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Shoulder arthroscopy is associated with severe postoperative pain. Traditionally, the interscalene approach to the brachial plexus has been employed to manage postoperative pain following shoulder surgery.To provide more complete shoulder joint analgesia, suprascabular nerve block (SSNB) was combined with block of the circumflex nerve which comes from the posterior cord of the brachial plexus that usually gives also upper subscapular, thoracodorsal, lower subscapular and radial nerves.

Detailed description: Aim of the work is to compare postoperative analgesic effect of ultrasound guided combined suprascapular and circumflex nerve blocks versus suprascapular nerve and posterior cord blocks at infraclavicular level .

Thirty four patients aged from 18-70 years old, with ASA physical status I-II-III and scheduled for shoulder surgeries will be included in the study. Patients will be randomly allocated using computer-generated table into one of two groups:

* Group circumflex → will undergo ultrasound guided SSN+circumflex.
* Group posterior cord → will undergo ultrasound guided SSN+posterior cord.

Eligibility criteria: Inclusion Criteria:

* ASA I-II.-III
* Undergoing shoulder arthroscopy.

Exclusion Criteria:

* Patient refusal
* Known allergy to local anesthetics
* Bleeding disorders
* Inability to provide informed consent

Primary outcomes:
measure: Time of the first postoperative analgesic request
timeFrame: 12 hours postoperative
Secondary outcomes:
measure: Visual analogue score
timeFrame: 12 hours postoperative
measure: Total morphine consumption
timeFrame: 12 hours postoperative
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Anesthesia Department
Study officials:
affiliation: Cairo University
name: Mohamed Abd-Elraouf Nasr
role: PRINCIPAL_INVESTIGATOR
affiliation: Cairo University
name: Ahmed Zaghloul
role: STUDY_DIRECTOR
affiliation: Cairo University
name: Mohsen Waheb
role: STUDY_DIRECTOR
References:
citation: Axelsson K, Gupta A, Johanzon E, Berg E, Ekback G, Rawal N, Enstrom P, Nordensson U. Intraarticular administration of ketorolac, morphine, and ropivacaine combined with intraarticular patient-controlled regional analgesia for pain relief after shoulder surgery: a randomized, double-blind study. Anesth Analg. 2008 Jan;106(1):328-33, table of contents. doi: 10.1213/01.ane.0000297297.79822.00.
citation: Price DJ. The shoulder block: a new alternative to interscalene brachial plexus blockade for the control of postoperative shoulder pain. Anaesth Intensive Care. 2007 Aug;35(4):575-81. doi: 10.1177/0310057X0703500418.
citation: Lyons C, Herring AA. Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess. Am J Emerg Med. 2017 Jul;35(7):1032.e3-1032.e7. doi: 10.1016/j.ajem.2017.01.064. Epub 2017 Feb 1.