Pain
Conditions
Keywords
ultrasound, nerve stimulator
Brief summary
The investigators compared the postoperative analgesia of nerve stimulator-guided and ultrasound-guided interscalene block after shoulder surgery.
Detailed description
Ultrasound (US)-guided peripheral nerve block has increased in popularity. It has many advantages such as improved success rate, faster onset time, fewer needle passes, shorter performance time, and reduced procedural pain and vascular puncture. However, there is no information about postoperative analgesia. Therefore, the investigators tested whether nerve stimulator (NS) - guided interscalene block was inferior to ultrasound-guided block in terms of duration of postoperative analgesia for shoulder surgery.
Interventions
PROCEDURENS-guided interscalene block
Patients received a standard single injection interscalene block using the modified lateral approach of Borgeat. The interscalene brachial plexus was identified using an insulated needle connected to a nerve stimulator. An insulated needle attached to a nerve stimulator was used to identify the brachial plexus. Placement of the needle was considered adequate if the deltoid, triceps, pectoralis, or biceps muscle motor response was still present at 0.2 - 0.5mA. Ropivacine 0.75% 20ml was used.
PROCEDUREUS-guided interscalene block
Interscalene block is performed under ultrasound guidance. Linear probe is placed on the ipsilateral interscalene groove visualizing the brachial plexus located between anterior and middle scalene muscles. Using in-plane technique, an insulated needle is advanced into the brachial plexus sheath, into which 20 ml of 0.75% ropivacaine is injected
Sponsors
Cheju Halla General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists physical class I - III patients scheduled to undergo shoulder surgery
Exclusion criteria
* coagulopathy, severe pulmonary disease, neuropathy, contralateral diaphragmatic paresis, allergy to study medications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| duration of postoperative analgesia | at 24h after surgery | time from completion of local anesthetic injection until the first request for an analgesic |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| patient discomfort (pain score (0 -10) during the procedure) | at 30 min after block placement | pain score (0 -10) during the procedure |
| block performance time (the time between the block needle insertion and needle withdrawal) | at 30 min after block placement | the time between the block needle insertion and needle withdrawal. |
| The number of needle redirections | at 30 min after block placement | either forward or backward movement of needle at least 1 cm or more |
| paresthesia (presence of paresthesia during the procedure) | at 30 min after block placement | presence of paresthesia during the procedure |
| onset time (complete block of sensory and motor nerve) | until 30min after completion of local anesthetic | complete block of sensory and motor nerve |
| paresthesia of hand | at 30 min after block placement | presence of paresthesia in the operated hand |
| Supplemental analgesia | at 24h after surgery | — |
| Pain score | at 24h after surgery | numerical rating scale (0 - 10) |
| Patient satisfaction | at 24h after surgery | Patient satisfaction was evaluated using a two-point score: 1, satisfactory (if necessary, I would have the same anesthetic technique); and 2, unsatisfactory (different anesthetic technique). |
| motor block of hand | at 30 min after block placement | degree of motor block in the operated hand |
Countries
South Korea
Outcome results
None listed