Arthroscopic Shoulder Surgery, Postoperative Pain
Conditions
Keywords
Interscalene block, Anterior suprascapular block, Pericapsular nerve group block, Shoulder Block, Arthroscopic shoulder surgery, Pain, acute, Pain, Postoperative
Brief summary
Interscalene block is widely accepted as the gold-standard regional analgesic technique for pain control after arthroscopic shoulder surgery. However, because this block is performed at the level of the brachial plexus roots, it may be associated with adverse effects such as phrenic nerve blockade and subsequent diaphragmatic dysfunction. These limitations have prompted the search for alternative regional anesthesia techniques that can provide effective postoperative analgesia while preserving respiratory function. The anterior suprascapular block, which covers a broad dermatomal distribution of the shoulder region, has been shown in some studies to provide sufficient analgesia as a standalone technique. In addition, the pericapsular nerve group (PENG) block of the shoulder-applied around the anterior capsule and performed at a distance from critical neurovascular structures that may lead to serious complications-may represent another potential analgesic option following arthroscopic shoulder procedures. Therefore, this study aims to evaluate alternative regional block techniques in comparison with the interscalene block and to contribute to the identification of an optimal analgesic strategy after arthroscopic shoulder surgery.
Interventions
PROCEDUREInterscalene block
Interscalene block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.
PROCEDUREAnterior suprascapular block
Anterior suprascapular block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.
PROCEDUREPericapsular nerve group (PENG) block
Pericapsular nerve group (PENG) block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.
Sponsors
Atatürk Chest Diseases and Chest Surgery Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients with ASA scores I-II-III * Patients scheduled for elective arthroscopic shoulder surgery * Patients who have been informed about the study and have given written consent will be included.
Exclusion criteria
* Those with a known allergy to local anesthetics * Those with an infection at the application site * Those with a severe coagulopathy disorder or anticoagulant use * Those with contralateral phrenic nerve palsy or a serious pulmonary diagnosis * Those with a history of chronic opioid use or neuropathic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | First hour after the surgery | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain) at the first postoperative hour. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | First 24 hours after surgery | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain). Pain assessment will be done at the 1st, 2nd, 6th, 12th, and 24th hours after surgery. |
| Forced vital capacity (FVC) (volume) | Perioperative period | Forced vital capacity (FVC) (volume) will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1, 12, and 24 hours. |
| Forced expiratory flow in 1 s (FEV1) (volume) | Perioperative period | Forced expiratory flow in 1 s (FEV1) (volume) will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1, 12, and 24 hours. |
| FEV1/FVC | Perioperative period | FEV1/FVC will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1, 12, and 24 hours. |
Countries
Turkey (Türkiye)
Outcome results
None listed