Continuous Cervical Erector Spinae Plane Block Versus Interscalene Nerve Block in Shoulder Arthroscopic Surgery
Continuous Cervical Erector Spinae Plane Block Versus Interscalene Nerve Block in Shoulder Arthroscopic Surgery- A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study is a prospective randomized controlled trial designed to evaluate whether continuous cervical erector spinae plane block (ESPB) is non-inferior to continuous interscalene block (ISB) for postoperative pain control in adult patients undergoing elective shoulder arthroscopic surgery. Eligible participants will be allocated to one of three groups: continuous cervical ESPB, continuous ISB, or a prospective observational control group receiving standard institutional analgesia with single-shot ISB.
Randomization with allocation concealment will be applied to the two interventional groups. Patients and outcome assessors will be blinded to group allocation. All regional anesthesia techniques will be performed as part of a standardized multimodal analgesic protocol.
The primary outcome is postoperative pain intensity measured using the visual analogue scale (VAS) at 24 hours after surgery. Secondary outcomes include pain scores at additional postoperative time points, cumulative opioid consumption expressed as oral morphine equivalents, measures of functional recovery, and the incidence of block-related adverse events. Respiratory-related outcomes, including hemidiaphragmatic paralysis assessed by ultrasound, as well as motor and sensory deficits and postoperative nausea and vomiting, will also be evaluated.
Analyses of the randomized intervention groups will be conducted on an intention-to-treat basis. Data from the observational control group will be analyzed descriptively to provide reference information on usual-care outcomes.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Chung-Ren Dr. Lin, PhD
- Phone Number: 06-2353535
- Email: n104065@mail.hosp.ncku.edu.tw
Study Contact Backup
- Name: Yu-Lien Hsieh, MD
- Email: hsiehyulien@gmail.com
Study Locations
-
-
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Tainan, Taiwan, 704
- National Cheng Kung University Hospital
-
Contact:
- Department of Anesthesiology
- Phone Number: +886-6-2353535 ext 5348
- Email: em75348@ncku.edu.tw
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients scheduled for elective shoulder arthroscopic surgery
Exclusion Criteria:
- Contraindications to regional analgesia
- BMI >40
- ASA physical status IV
- history of drug or opioid abuse
- preoperative upper limb motor impairment
- postoperative ventilator support or ICU admission
- Inability to provide self-reported pain assessments
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Continuous Cervical Erector Spinae Plane Block
Participants will receive an ultrasound-guided continuous cervical erector spinae plane block with perineural catheter placement as part of a standardized multimodal analgesia regimen for shoulder arthroscopic surgery.
Postoperative analgesia will be provided via continuous local anesthetic infusion through the catheter per institutional protocol.
|
An ultrasound-guided cervical erector spinae plane block with catheter placement will be performed.
Local anesthetic will be administered through the catheter to provide continuous postoperative analgesia according to institutional protocol as part of a standardized multimodal analgesic regimen.
|
|
Active Comparator: Continuous Interscalene Block
Participants will receive an ultrasound-guided continuous interscalene block with perineural catheter placement as part of a standardized multimodal analgesia regimen for shoulder arthroscopic surgery.
Postoperative analgesia will be provided via continuous local anesthetic infusion through the catheter per institutional protocol.
|
An ultrasound-guided interscalene block with catheter placement will be performed.
Local anesthetic will be administered through the catheter to provide continuous postoperative analgesia according to institutional protocol as part of a standardized multimodal analgesic regimen.
|
|
Other: Single-Shot Interscalene Block
Observational
|
as observational group
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative pain intensity within postoperative 24 hours
Time Frame: 2 hour, 6 hours, 12 hours, and 24 hours postoperatively
|
Postoperative pain intensity will be assessed using a 0-10 visual analogue scale (VAS) at 2, 6, 12, and 24 hours after surgery.
|
2 hour, 6 hours, 12 hours, and 24 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Motor blockade severity
Time Frame: Up to 48 hours postoperatively
|
Motor blockade severity in the operated upper extremity will be assessed using a standardized muscle strength grading scale ranging from 0 to 5, where 0 indicates no muscle contraction and 5 indicates normal muscle strength.
|
Up to 48 hours postoperatively
|
|
analgesic consumption
Time Frame: 48 hours
|
Rescue analgesic requirements and cumulative opioid consumption will be recorded and converted to oral morphine equivalent doses.
|
48 hours
|
|
Adverse events
Time Frame: 7 days
|
Adverse events will include postoperative nausea and vomiting, signs or symptoms of local anesthetic systemic toxicity, infection, neurologic symptoms, and catheter-related complications.
|
7 days
|
|
Duration of motor blockade
Time Frame: Up to 48 hours postoperatively
|
The duration of motor blockade will be defined as the time from completion of surgery to recovery of normal motor function, defined as a muscle strength grade of 5 on the standardized 0-5 muscle strength scale, in the operated upper extremity.
|
Up to 48 hours postoperatively
|
|
Sensory blockade distribution
Time Frame: Up to 48 hours postoperatively
|
The anatomical distribution of sensory blockade will be assessed using standardized sensory examination (e.g., response to pinprick or cold sensation) across predefined dermatomal regions of the operated upper extremity.
|
Up to 48 hours postoperatively
|
|
Duration of sensory blockade
Time Frame: Up to 48 hours postoperatively
|
The duration of sensory blockade will be defined as the time from completion of surgery to recovery of normal sensation in the operated upper extremity, as assessed by standardized clinical sensory examination.
|
Up to 48 hours postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- B-ER-114-324
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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