Regional Anaesthesia in Shoulder Arthroscopy: A comparative study

A comparison of efficacy of three techniques for regional anaesthesia in patients undergoing shoulder arthroscopy.

Status

Completed

Phases

Phase 4

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12617001546347

Enrollment

130

Registered

2017-11-09

Start date

2018-08-01

Completion date

2020-11-13

Last updated

2021-07-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

This study aims to compare the efficacy of three methods of regional anaesthesia in shoulder arthroscopy, as well as to compare patient satisfaction with the three methods. People undergoing shoulder arthroscopy will be invited to take part in the trial and will be randomised to one of three groups if they accept. The three groups comprise an Interscalene block, inserted by an anaesthetist; a combined suprascapular & axillary nerve block inserted by an anaesthetist;and the combined block inserted by the treating surgeon during the procedure. Outcomes examined by this study include pain levels after the operation (in the recovery room, the next day & out to a week later), how much pain relieving medication was used and how satisfied the participants were with their experience of regional anaesthesia (through use of a survey form). The findings of this study will be utilised to guide clinical practice in the use of regional anaesthesia in arthroscopic shoulder procedures.

Interventions

Arm 1 - Interscalene nerve block [brachial plexus block] (ISB), inserted under ultrasound-guidance by a consultant anaesthetist. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL with 0.9% saline - Single dose, prior to surgery. - Adherence not applicable, blocks inserted after the patient is under GA Arm 2 - Suprascapular Nerve Block + Axillary Nerve Block (SSNB+ANB), inserted under ultrasound-guidance by a consultant anaesthetist. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL with 0.9% saline - Single dose, prior to surgery. 10mL per nerve. - Adherence not applicable, blocks inserted after the patient is under GA Arm 3 - Suprascapular Nerve Block + Axillary Nerve Block (SSNB+ANB), inserted by arthroscopic guidance by a consultant orthpaedic surgeon. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL 0.9% saline - Single dose, during surgery, 10mL per nerve - Adherence not applicable, blocks inserted after the patient is under GA

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Blinded (masking used) (Subject)

Eligibility

Sex/Gender

All

Age

18 Years to 90 Years

Healthy volunteers

Inclusion criteria

Patients scheduled to undergo shoulder arthroscopy under the care of the investigating surgeons. Male and female Age 18-90 Able to provide informed consent Patients with BMI <40 Patients not currently taking regular opioid analgesics

Exclusion criteria

Patients with distorted anatomy that may negatively impact on block insertion Patients with pre-existing nerve injury/neuropathy affecting the innervation of the upper limb & shoulder. Patients with a known adverse drug reaction to the medications used in this study Patients with comorbid medical conditions that would contraindicate block insertion (i.e. ISB in severe COPD) Patients unable to comply with assessment requirements Patients with active infection Patients with BMI >40 Patients who are pregnant or planning on becoming pregnant during the course of the study Patients unable to provide informed consent

Outcome results