Clinical trial NCT04669639: A Comparison of ESP Block to SSN Block for Analgesia in Shoulder Surgery
Official title: A Comparison of Erector Spinae Plane Block to Suprascapular Nerve Block for Analgesia in Shoulder Surgery
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Arthroscopic Shoulder Surgery
Keywords: erector spinae plane block- suprascapular nerve
Lead sponsor: Zagazig University
Sponsor class: OTHER_GOV
First posted: 2020-12-17
Enrollment: 96
Sex: ALL
Minimum age (years): 21
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: There has been a recent renewed interest in using the suprascapular nerve block (SSNB) as a phrenic nerve sparing approach for analgesia after shoulder surgery. The suprascapular nerve provides 70% of the sensory input to the glenohumeral joint and also innervates the infraspinatus and supraspinatus muscles. However, some researchers suggest that SSNB alone cannot provide a sufficient analgesia.The high-thoracic erector spinae plane block (HT-ESPB) has been described in several case reports as an effective analgesic modality for the shoulder region without causing motor or phrenic nerve block
Primary purpose: OTHER

Brief summary: A comparison between Erector Spinae Plane block and Suprascapular nerve block in providing analgesia for shoulder surgery

Detailed description: Suprascapular nerve block is considered a phrenic nerve sparing approach that recently introduced as alternative for interscalene brachial plexus nerve block in shoulder surgery. However, some researchers reported that Suprascapular nerve block alone results in an ineffective analgesia. Erector Spinae Plane block is supposed to be able in providing adequate analgesia in shoulder surgery

Eligibility criteria: Inclusion Criteria:

* ASA I and II,
* Age above 21 years and below 60 years in both sexes,
* Cooperative patients,
* Patients with a BMI (body mass index) not exceeding 35.

Exclusion Criteria:

* patients with cardiovascular or respiratory compromise,
* Patient refusal,
* Coagulopathy,
* Local tissue infection,
* Allergy to local anesthesia,
* prior to cervical or thoracic spine surgery.

Primary outcomes:
measure: Intraoperative analgesia
timeFrame: The intraoperative patients' hemodynamics every 30 min were collected and analyzed till the end of surgery . Also the total dose of opioids consumed intraoperatively will be recorded. Postoperative consumed opioid for 24 hours also will calculated
Secondary outcomes:
Other outcomes:
Locations:
city: Zagazig
country: Egypt
facility: Faculty of Medicine, Zagazig University
Study officials:
References:
citation: Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg. 1991 Apr;72(4):498-503. doi: 10.1213/00000539-199104000-00014.
citation: Ma W, Sun L, Ngai L, Costouros JG, Steffner R, Boublik J, Tsui BCH. Motor-sparing high-thoracic erector spinae plane block for proximal humerus surgery and total shoulder arthroplasty surgery: clinical evidence for differential peripheral nerve block? Can J Anaesth. 2019 Oct;66(10):1274-1275. doi: 10.1007/s12630-019-01442-4. Epub 2019 Jul 9. No abstract available.
citation: Hussain N, Goldar G, Ragina N, Banfield L, Laffey JG, Abdallah FW. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017 Dec;127(6):998-1013. doi: 10.1097/ALN.0000000000001894.
citation: Abdelhaleem NF, Abdelatiff SE, Abdel Naby SM. Comparison of Erector Spinae Plane Block at the Level of the Second Thoracic Vertebra With Suprascapular Nerve Block for Postoperative Analgesia in Arthroscopic Shoulder Surgery. Pain Physician. 2022 Nov;25(8):577-585.