Arthroscopic Shoulder Surgery, Axillary Nerve Block, Suprascapular Nerve Block
Conditions
Brief summary
Arthroscopic shoulder surgery is associated with severe pain postoperatively. Regional nerve block adding to general anesthesia might improve the quality of postoperative analgesia. The aim of the study is to compare the subacromial local anesthetic infiltration and the suprascapular-axillary nerve blocks combination for intraoperative sevoflurane consumption, postoperative analgesia and analgesic consumption.
Detailed description
After informed consent and with ethics approval, 60 ASA 2-3 patients scheduled for elective arthroscopic shoulder surgery will be included in this study. Patient will be divided to two groups by using computer -generated list for randomization. In group A, the surgeon will apply 20 ml of 0.250% bupivacaine to the subacromial region at the end of the procedure. In Group B, suprascapular (10 ml of 0.250% bupivacaine ) and axillary block (10 ml of 0.250% bupivacaine) will be performed with ultrasound and nerve stimulator guidance before induction of anesthesia. In all patients after standard and BIS (Bi spectral index) monitorization general anesthesia will be induced with remifentanil (10mcg iv), propofol (2.5 mg/kg iv) and rocuronium (0.5mg/kg iv). After intubation, anesthesia will be maintained with 50% O2 and N2O mixture. Hemodynamic parameters, BIS values, end-tidal sevoflurane consumption will be recorded by blind investigator. Postoperative visual analog scale (VAS) values, postoperative analgesic consumption (Tramadol, patient controlled analgesia), complications will be recorded.
Interventions
PROCEDURESuprascapular nerve- axillary nerve block combination
In Group B, suprascapular (10 ml of 0.250% bupivacaine ) and axillary block (10 ml of 0.250% bupivacaine) will be performed with ultrasound and nerve stimulator guidance before induction of anesthesia
PROCEDURESubacromial infiltration
In group A, the surgeon will apply 20 ml of 0.250% bupivacaine to the subacromial region at the end of the procedure
Sponsors
Diskapi Teaching and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* American society of anesthesia physical status (ASA) 1,2 patients * Elective arthroscopic shoulder surgery
Exclusion criteria
* ASA 3,4 patients * Coagulation abnormality * Body mass index \>30 * Preexisting neurological deficit Local anesthetic allergy history Diabetes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative VAS scores | Through postoperative period, an avarage of 30 minutes | Ranging from 0: no pain to 10: worst pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| sevoflurane consumption | 5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia | End tidal sevoflurane concentration values assesment during the surgery |
Other
| Measure | Time frame | Description |
|---|---|---|
| Bleeding assesment | 5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia | stage1: Good surgical visualization (numeric rating scale 7\<), Stage 2: Moderate bleeding (numeric rating sacle =4-7), Stage 3: Severe bleeding, bad surgical visualization (numeric rating scale \< 4) |
Countries
Turkey (Türkiye)
Outcome results
None listed