Anterior Glenoid Nerve Block, Interscalene Brachial Plexus Block, Pericapsular Nerve Group Block, Postoperative Pain, Shoulder Arthroscopic Surgeries
Conditions
Brief summary
This study aims to compare between Anterior glenoid nerve block, pericapsular nerve group (PENG) block and Interscalene brachial plexus (ISB) block for post-operative pain management in shoulder arthroscopic surgeries
Detailed description
Major surgeries of the shoulder constitute some of the most commonly performed orthopedic procedures. They often result in moderate to severe postoperative pain thereby requiring a multimodal analgesic approach centered around peripheral nerve blocks. Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Interscalene blocks (ISB) are well-studied and established means of providing analgesia following shoulder surgery and are considered the gold standard mode of regional anesthesia and post-operative pain management in shoulder surgeries. A novel technique: pericapsular nerve group (PENG) block can be effectively and safely applied under ultrasound guidance in shoulder surgery cases for postoperative analgesia. In addition, PENG block targets articular branches with less motor effect compared with interscalene brachial plexus block providing anesthetic and analgesic effect with less complication and better and sooner ambulation.
Interventions
OTHERInterscalene brachial plexus block
Patients will receive an Interscalene brachial plexus block.
OTHERAnterior glenoid nerve block
Patients will receive an anterior glenoid nerve block.
OTHERPericapsular nerve group block
Patients will receive a pericapsular nerve group (PENG) block.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 70 years. * No sex predilection. * American Society of Anesthesiology (ASA) physical status I-II. * Undergoing shoulder arthroscopic surgeries.
Exclusion criteria
* Patient's refusal. * Patients with a history of drug allergies to study drugs. * Evidence of local infection at the site of injection. * Inability to cooperate * Neuromuscular pathology (example: - Multiple Sclerosis) * Previous trauma or surgery to the shoulder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the 1st rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia (time from the end of surgery to the first dose of pethidine administrated). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total pethidine consumption | 24 hours postoperatively | All patients will receive intravenous pethidine (30mg) on demand \[Visual Analogue Scale (VAS) score ≥3\]. |
| Degree of pain | 24 hours postoperatively | Degree of pain will be assessed using visual analogue scale (VAS). Each patient will be instructed about postoperative pain assessment with the VAS. VAS (0 represents no pain while 10 represents the worst pain imaginable). VAS will be assessed at 0, 6, 12, and 24 hours postoperatively. |
| Length of hospital stay | Till discharge from hospital (Up to one week). | Length of hospital stay will be recorded from admission till the discharge from hospital. |
| Time needed for the patient to freely move the operated limb | Postoperatively (Up to one week). | Time needed for the patient to freely move the operated limb will be recorded. |
| Degree of patients satisfaction | 24 hours postoperatively | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) |
Countries
Egypt
Contacts
Primary ContactMohamed Serry, Master
Outcome results
None listed