Shoulder Pain
Conditions
Brief summary
Our current standard of care is to perform an interscalene peripheral nerve block for patients receiving rotator cuff repair surgery as it is an effective opioid-free alternative for post-operative pain control. However, many of these repairs require a supplemental incision for an open biceps tenodesis, which is not covered by the interscalene block. The intercostobrachial nerve covers this incision and is targeted by an axillary ring block or a single shot nerve block in the fascial plane between the pectoralis minor and serratus anterior muscles (otherwise termed as a PECS II block). This study will attempt to delineate if one is superior in postoperative analgesia and mitigating intraoperative stimulation by comparing an axillary ring block to a PECS II block. Patients receiving a rotator cuff repair with biceps tenodesis without histories of chronic opioid use and respiratory compromise will be eligible to be enrolled in the study. All patients will receive an interscalene block and group 1 will receive a supplemental axillary ring block and group 2 will instead receive a PECS II block. After surgery, the patients' pain score will be assessed upon PACU arrival, at 6 hours after block, and 2 weeks postoperatively. Their opioid requirements will also be assessed. Our primary outcome is pain score at 6 hours following the block.
Interventions
PROCEDURENerve Block - either PECS II or axillary ring
In addition to an interscalene nerve block, one of these two interventions will be administered to assess pain control after a biceps tenodesis
Sponsors
University of Southern California
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
Patient and Provider won't be aware of what block will be administered until just before the nerve block is done
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* medically optimized patients who will undergo an elective surgery for an arthroscopic rotator cuff repair with open biceps tenodesis
Exclusion criteria
* women who are pregnant or breastfeeding, history of chronic opioid use, respiratory compromise, smokers, or allergy to local anesthetics or opioids.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Visual Analog Score at 6 hours following the block | 6 hours post-block |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Morphine milligram equivalents (MME) | Right after surgery and 2 weeks | MMEs in recovery room after surgery and 2 weeks after surgery via phone call |
| Intraoperative Stimulation | 2 hours during surgery | Whether patient displayed signs of pain (movement, elevated blood pressure or heart rate) under moderate sedation in the operating room |
Countries
United States
Contacts
Primary ContactPaul Lee, MD
Outcome results
None listed