- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02916342
Interscalene Block Versus Combined Supraprascapular: Axillary Nerve Blocks
Interscalene Brachial Block Versus Combined Supraprascapular: Axillary Nerve Blocks - Respiratory and Acute Pain-related Outcomes
The interscalene block provides effective analgesia after shoulder surgery. It consists of injecting local anaesthetic within the brachial plexus, in the interscalene groove, between the anterior and middle scalene muscles. Unfortunately, this technique is associated with respiratory complications such as hemidiaphragmatic paresis due to the spread of the local anaesthetic towards the phrenic nerve that lies close to the brachial plexus, with an incidence up to 100%. The diaphragmatic paresis may be a serious side-effect, especially in patients suffering from a reduced respiratory function such as chronic obstructive pulmonary disease; this entity may even represent a contraindication to the performance of the block.
The shoulder is mainly innervated by the suprascapular and axillary nerves, both of them coming from C5 and C6 branches of the brachial plexus block. Recently, several authors have successfully identified and block these two nerves under ultrasound guidance. Only one randomised controlled trial compared interscalene block with a combination of suprascapular and axillary nerve blocks, and showed inconclusive results probably due to the absence of ultrasound guidance; indeed, analgesia was equivalent at the sixth postoperative hour, while patients with an interscalene block had reduced pain scores in the recovery room. Besides, the authors did not investigate the impact on the respiratory function.
In that randomised controlled trial, the investigators would like to compare the analgesic efficacy and the respiratory outcomes between the interscalene block and the combined suprascapular-axillary nerve blocks.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Vaud
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Lausanne, Vaud, Switzerland, 1011
- Lausanne University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ASA physical status I-III;
- 18-85 years of age, inclusive;
- surgery less than 3 hours.
Exclusion Criteria:
- indication for catheter insertion;
- contraindications to brachial plexus block (e.g., allergy to local anaesthetics, malignancy or infection in the area);
- existing neurological deficit in the area to be blocked;
- pregnancy;
- history of neck surgery or radiotherapy;
- severe respiratory disease;
- chest deformity;
- inability to understand the informed consent and demands of the study;
- patient refusal.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Interscalene brachial plexus block
An ultrasound-guided interscalene brachial plexus block will be performed prior to surgery.
|
Patients will receive an ultrasound-guided interscalene brachial plexus block before general anaesthesia.
|
Experimental: Supraclavicular-axillary nerve blocks
A dual supraclavicular-axillary nerve blocks will be performed prior to surgery.
|
Patients will receive ultrasound-guided supraclavicular and axillary nerve blocks before general anaesthesia.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Presence of hemidiaphragmatic paresis (yes/no)
Time Frame: 30 minutes after the injection
|
30 minutes after the injection
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Forced expiratory volume in 1 second (liters)
Time Frame: 30 minutes after the injection
|
30 minutes after the injection
|
|
Peak expiratory flow (liters/minute)
Time Frame: 30 minutes after the injection
|
30 minutes after the injection
|
|
Forced vital capacity (liters)
Time Frame: 30 minutes after the injection
|
30 minutes after the injection
|
|
Pain scores in phase 1 recovery (visual analogue scale, 0-10)
Time Frame: 2 hours after surgery
|
Visual analogue scale, 0-10
|
2 hours after surgery
|
Pain scores at 24 hours postoperatively (visual analogue scale, 0-10)
Time Frame: Postoperative day 1
|
Visual analogue scale, 0-10
|
Postoperative day 1
|
Intravenous morphine consumption in phase 1 recovery (mg)
Time Frame: 2 hours postoperatively
|
2 hours postoperatively
|
|
Oxycodone consumption at 24 hours postoperatively (mg)
Time Frame: Postoperative day 1
|
Postoperative day 1
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 2016-00889
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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