Arthroscopic Shoulder Surgery
Conditions
Keywords
serratus posterior superior intercostal plane block, shoulder arthroscopy, regional anesthesia, plane block, postoperative pain
Brief summary
Patients undergoing arthroscopic shoulder surgery often experience moderate to severe postoperative pain. Various medical treatments are employed to provide analgesia for these patients. The advancement of regional anesthesia techniques has made possible to both reduce the use of narcotic analgesics and provide long-term pain management benefits. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB) was first described in 2023 by Serkan Tulgar et al. Cadaveric studies and dermatomal analyses in patients have demonstrated its ability to provide analgesia in the back, neck, shoulder, axilla, and lateral thoracic regions. Even though patients undergoing shoulder surgery benefit from the block; once the duration of a single-shot block wears off, they may experience severe pain again. The aim of this study is to investigate the analgesic effects of a single-shot SPSIPB compared to catheter-based SPSIPB with intermittent postoperative bolus administration provided by placing a catheter in this region. The hypothesis of this study: In arthroscopic shoulder surgery, the intermittent bolus administration of the serratus posterior superior intercostal plane block using a catheter will result in lower pain scores, reduced opioid consumption, and improved patient satisfaction compared to single-shot application.
Interventions
OTHERSerratus posterior superior intercostal plane block (single-shot)
30 mL of 0.25% bupivacaine will be injected as single-shot block 20 mins prior to surgery
OTHERSerratus posterior superior intercostal plane block (catheter-based intermittent bolus)
Patients in this group will receive an ultrasound-guided serratus posterior superior intercostal plane block with 30 mL of 0.25% bupivacaine before surgery. Following the initial block, a catheter will be placed in the serratus posterior superior intercostal plane. Postoperatively, 0.25% bupivacaine at a dose of 30 mL will be administered through the catheter as an intermittent bolus every 8 hours.
Sponsors
Goztepe Prof Dr Suleyman Yalcın City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Aged between 18-80 years * No bleeding diathesis * Classified as ASA I-II-III
Exclusion criteria
* Patients who do not provide consent * Patients with coagulopathy * History of allergy or intoxication to local anesthetic agents * Patients with advanced organ failure * History of neuropathic disease * Patients with mental retardation * Presence of infection at the injection site * Conditions in which regional anesthesia is contraindicated * Pediatric patients and those over 80 years of age * Pregnant patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Opioid Consumption | Postoperative 24 hours | Patient-Controlled Analgesia (Tramadol) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Scores | Postoperative 24 hours | Tha pain will be assessed with Numeric Rating Scale at 0, 30 minutes, 1, 4, 8, 12, and 24 hours. |
| Patient Satisfaction (Likert scale) | Post surgery 24 hours | — |
| Postoperative Nausea and Vomiting Scale | 24 hours | — |
| Perioperative Remifentanyl Consumption | Perioperative assessment | — |
| Use of Rescue Analgesics in the Ward | 24 hours | — |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORSenem Koruk
Goztepe Prof Dr Suleyman Yalcın City Hospital
Outcome results
None listed