Clinical trial NCT06973447: Combined ASSNB and ICBPB vs CCBPB in Shoulder Arthroscopy
Official title: Comparison of the Effects of Combined Anterior Suprascapular Nerve Block and Infraclavicular Brachial Plexus Block Versus Costoclavicular Brachial Plexus Block on Postoperative Pain and Hemidiaphragmatic Paralysis in Shoulder Arthroscopy
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Postoperative Pain
Shoulder Arthroscopy
Keywords: postoperative pain
shoulder arthroscopy
regional anesthesia
costoclavicular brachial plexus block
infraclavicular brachial plexus block
anterior suprascapular nerve block
Lead sponsor: Cumhuriyet University
Sponsor class: OTHER
First posted: 2025-05-15
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: The aim is to compare the postoperative analgesic and hemidiaphragmatic effects of Anterior SupraScapular Nerve Block (ASSNB) and InfraClavicular Brachial Plexus Block (ICBPB) combination versus CostoClavicular Brachial Plexus Block (CCBPB) in patients undergoing shoulder arthroscopic surgery.

Detailed description: Patients were divided into two randomized groups: Group 1 (ASSNB+ICBPB Combination group, n=15) and Group 2 (CCBPB group, n=15). All patients will receive the same standard general anesthesia per hospital protocol. All blocks will be applied with the same ultrasonography and block equipment, and by the same physician. Before the anesthesia induction, ipsilateral diaphragmatic excursion will be measured via Ultrasonography (USG). After the anesthesia induction, patients in Group 1 will receive anterior suprascapular nerve block (ASSNB) with 10 mL of 0.25% bupivacaine and infraclavicular brachial plexus block (ICBPB) with 15 mL of 0.25% bupivacaine (with a total volume of 25 mL). Patients in Group 2 will receive costoclavicular brachial plexus block (CCBPB) with 15 mL of 0.25% bupivacaine. All patients will receive Paracetamol 1gr and Dexketoprofen 50mg intravenous (IV) 10 minutes prior to skin closure. After 30 minutes of emergence from anesthesia (upon reaching 9 points on modified Aldrete scoring), ipsilateral diaphragmatic excursion will be assessed again. Pre- and postblock excursion differences will be recorded. Routine analgesic procedure consisting of 3x1gr Paracetamol and 2x50mg Dexketoprofen will be followed postoperatively for 24 hours. Numeric Rating Scale (NRS) will be used to assess postoperative pain on 1st, 6th, 12th, 18th and 24th hours after the surgery. Quality of Recovery-15 Patient Survey will be done both preoperatively for a baseline score, and postoperatively at 24th hour to assess the quality of recovery from the patients' view. Tramadol 50mg IV will be administered as a rescue analgesic for all patients if NRS score is higher than 4. Total Tramadol consumption will be calculated.

Eligibility criteria: Inclusion Criteria:

* Adult patients older than 18 years of age who underwent arthroscopic shoulder surgery under general anesthesia and were American Society of Anesthesiologists (ASA) I-II-III according to the ASA risk classification.

Exclusion Criteria:

* patients who did not give consent,
* patients with coagulopathy,
* patients with signs of infection at the block application site,
* patients using anticoagulants,
* patients with local anesthetic drug allergies,
* patients with unstable hemodynamics,
* patients who could not cooperate during postoperative pain assessment

Primary outcomes:
measure: Numeric Rating Scale (NRS) Scores
timeFrame: Postoperative 24 hours
measure: Diaphragmatic Excursion Difference
timeFrame: Preoperatively right before the anesthesia induction, and postoperatively after 30 minutes of emergence from anesthesia (upon reaching 9 points on modified Aldrete scoring)
Secondary outcomes:
measure: Quality of Recovery-15 Patient Survey (QoR-15)
timeFrame: Preoperatively and Postoperatively at 24th hour
measure: Total tramadol consumption
timeFrame: Postoperative 24 hours
Other outcomes:
Locations:
city: Sivas
country: Turkey
facility: Sivas Cumhuriyet University
Study officials:
affiliation: Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation
name: Oğuz Gündoğdu
role: PRINCIPAL_INVESTIGATOR
References: