Perioperative Pain
Conditions
Brief summary
When someone experiences a shoulder dislocation, it can be extremely painful. Emergency physicians often choose to use conscious sedation to help reduce the pain. However, some patients may not be able to tolerate conscious sedation due to concerns about their ability to breathe properly or the risk of inhaling fluids. A recently developed technique called Ultrasound-guided Pericapsular Nerve Group (PENG) block is used to block the articular branches of the shoulder and the pericapsular spread around the glenohumeral joint. The PENG block is commonly used in hip surgery and is effective in providing motor-sparing analgesic results.
Detailed description
When someone experiences a shoulder dislocation, it can be extremely painful. Emergency physicians often choose to use conscious sedation to help reduce the pain. However, some patients may not be able to tolerate conscious sedation due to concerns about their ability to breathe properly or the risk of inhaling fluids. In an ideal scenario, the surgeon could achieve complete pain control and muscle relaxation without compromising the patient's airway. There are various techniques available to facilitate shoulder reduction, including interscalene block, general anesthesia, and intravenous analgesia. All of these methods can help the surgeon ease the patient's pain and reduce the likelihood of complications.1 When choosing the anesthesia method for reducing ASD, the top priority is ensuring the patient's comfort through pain management. The anesthesia helps to relax the muscle spasms, making it easier to reduce the ASD. The goal is to relocate the shoulder with minimal risk of complications. A recently developed technique called Ultrasound-guided Pericapsular Nerve Group (PENG) block is used to block the articular branches of the shoulder and the pericapsular spread around the glenohumeral joint. The PENG block is commonly used in hip surgery and is effective in providing motor-sparing analgesic results.
Interventions
DRUGPropofol injection and fentanyl
The sequence will be to inject fentanyl 1 μg•kg-1•min-1 first within 1 min and then inject propofol 2 mg•kg-1•min-1.
DRUGBupivacain
Patients will be anesthetized with ultrasound-guided pericapsular nerve group block (PENG block) using 20 ml of 0.25% bupivacaine.
Sponsors
Benha University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* (ASA )classes I and II * patients of either sex, above the age of 18 * patients will undergo dislocated shoulder
Exclusion criteria
* the patient's refusal to participate * coagulation disorders * allergy to local anesthetic * history of daily opioid intake * patients with cognitive impairments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| length of hospital stay | 1st 24 hours | the period when the patient stayed in the hospital |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| reduction time | 1st hour after intervetion | the period from the beginning to the end of reduction |
| the visual analogue scale(VAS) | 30 minutes ,2,4,8,12 hours postoperative | ranges from 0 to 10, with 0 representing no pain and 10 being the most intense pain possible. |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORFatma Ah Abdelfatah, MD
banha faculity of medicine
Outcome results
None listed