Analgesia
Conditions
Keywords
shoulder anterior capsular block, intraarticular steroid injection, adhesive capsulitis
Brief summary
Improving pain in the patients with adhesive capsulitis by comparing the effect of combined shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection.
Detailed description
Comparing between combined shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection for enhancing pain relief in adhesive capsulitis as regards: * To measure analgesic parameters including: assessment of pain score by using Visual Analogue Score during 8 weeks follow up in comparison to baseline and total amount of rescue analgesic (ibuprofen) consumption. * To assess the Shoulder pain and Disability Index * To record complications of the block (local anesthetic toxicity, infection, bleeding, nerve injury) * Over all patient's satisfaction: The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia).
Interventions
PROCEDUREGroup Group Shoulder anterior capsular block (SHAC)
patients will receive ultrasound guided (SHAC) block combined with intraarticular steroid injection of the affected shoulder joint followed by home exercise program.
PROCEDUREGroup intraarticular steroid injection (IASI)
patients will receive intraarticular steroid injection of the affected shoulder joint followed by home exercise program
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The outcome assessors are blind to the study groups
Intervention model description
pain relief in adhesive capsulitis by comparing shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection
Eligibility
Sex/Gender
ALL
Age
41 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients acceptance * Age: 41-65 years old * Sex: both sex (males or females). * Physical status: American Society of Anesthesiologist (ASA) І, II. * Patients attend orthopedic or pain clinic with complaint of shoulder pain and stiffness. These patients received conservative management of pain with no relief of symptoms for at least 2 weeks.
Exclusion criteria
* Shoulder pain due to secondary causes, e.g. acute trauma, fractures, bony deformity, glenohumeral joint pathology, acromioclavicular joint pathology and rotator cuff disorder. * Patient with any contraindications of regional blocks (as coagulopathy or local infection at injection site) * Patients with known history of allergy to the study drugs (bupivacaine and methylprednisolone). * Advanced hepatic, renal, cardiovascular, neurologic and respiratory diseases, uncontrolled diabetes mellitus and thyroid. * History of neuropathy in the involved limb or previous revision surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | BEFORE STARTING PROCEDURE (0 hour)(baseline) | measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of Shoulder Pain and Disability Index (SPADI) | baseline (0 ) and subsequently at one week, 3 weeks , 6 weeks and 8 weeks after procedure | SPADI contains 13 items that assess two domains - a five item subscale that measures pain and an eight item subscale that measures disability. Each subscale scored 10 ranging from 0 (best) to 10 (worst). It is a self administered, valid questionnaire, |
| Total amount of rescue analgesia | first 24 hours | Total amount of rescue analgesia (ibuprofen) |
| patient's satisfaction | 1 week after procedure | degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia) |
| Complications of SHAC block | 24 hours | Complications of SHAC block (local anesthetic toxicity, infection, bleeding) |
| PASSIVE AND ACTIVE RANGE OF MOTION | at baseline, first week and third week follow up post intervention. | Passive and active shoulder flexion, abduction, and external rotation will be measured using goniometer |
Countries
Egypt
Contacts
Primary ContactDina Salem, MD
Outcome results
None listed