Rotator Cuff Tear, Pain
Conditions
Keywords
Suprascapular nerve block, Interscalene nerve block
Brief summary
Most arthroscopic surgeries of the shoulder are currently performed as an outpatient. The postoperative analgesia should be optimal. General anesthesia allows for any arthroscopic surgery but does not provide a satisfactory postoperative analgesia . The locoregional anesthesia is recommended and includes several techniques: the interscalene nerve block, the suprascapular nerve block, intra-articular injection of local anesthetic and subacromial infiltration. The interscalene nerve block is currently the gold standard for anesthesia and postoperative analgesia for arthroscopic shoulder surgery with a success rate above 80% . However it must be carried out by teams experienced in the locoregional anesthesia because it is operator -dependent. The suprascapular nerve block is a simple technique that can be performed by the surgeon after surgery , effective in arthroscopic shoulder surgery , less invasive than the interscalene nerve block and exposing the patient to fewer complications. However, his interest was not assessed in the repair of tendons of the rotator cuff. The main hypothesis of this study is that the suprascapular nerve block is as effective as the interscalene nerve block in the prevention of early postoperative pain after arthroscopic repair of the infra and / or the supraspinatus rotator cuff tendons, without increasing the analgesic consumption while reducing the risk of complications related to regional anesthesia.
Interventions
PROCEDURESuprascapular nerve block
PROCEDUREInterscalene nerve block
Sponsors
Hospital Ambroise Paré Paris
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged over 18 years * Arthroscopic repair of infra and / or supraspinatus tendon of the rotator cuff with or without associated procedure on the biceps, the acromion-clavicular joint or acromion * Informed consent
Exclusion criteria
* Allergy to local anesthetics (ropivacaine, bupivacaine, xylocaine) * Previous surgery on the involved shoulder * Severe or morbid obesity (BMI\> 35) * Psychiatric disorders (impossible self-assessment of the pain) * Patient unfit physically, mentally or legally to give informed consent * Patient refusal * Pregnant or lactating women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Self-assessment of the mean shoulder pain | Visual analog scale (VAS) during 2 days postoperatively |
Secondary
| Measure | Time frame |
|---|---|
| Self assessment of shoulder pain | VAS twice daily during the first postoperative week |
| Complications of locoregional anesthesia | Yes or No during the first 24 hours |
Countries
France
Outcome results
None listed