Combined Anterior Suprascapular Nerve Block and Superficial Cervical Plexus Block In Shoulder Arthroplasty Surgery

Application Of Combined Anterior Suprascapular Nerve Block and Superficial Cervical Plexus Block In Reverse Shoulder Arthroplasty Surgery, A Case Series

The suprascapular nerve, originating from the C5 trunk, provides innervation to the acromioclavicular and glenohumeral joints. The supraclavicular nerve, a branch of the cervical plexus, contributes to the sensory innervation of the upper deltoid region. Cervical and brachial plexus blocks can cause diaphragm paralysis. This study examined the effects of low-volume combined anterior suprascapular nerve block and superficial cervical plexus block on pain and phrenic nerve in participants underwent reverse shoulder arthroplasty surgery.

Study Overview

• Status: Active, not recruiting
• Conditions: Diaphragmatic Paralysis; Phrenic Nerve Paralysis; Anterior Suprascapular Nerve Block; Superficial Cervical Plexus Block

Detailed Description

A retrospective analysis was performed on data obtained from eight participants who underwent reverse shoulder arthroplasty surgery. Anterior suprascapular nerve block and superficial cervical plexus block were applied to these participants. Anterior suprascapular nerve block was performed using 5 ml and superficial cervical plexus block was performed using 3 ml of %0,5 bupivacaine. Ultrasound was used to measure the diaphragm thickness at the end of inspiration and expiration, and to calculate the diaphragm thickness fraction. Postoperative pain management included patient-controlled analgesia with morphine, opioid consumption and VAS score recorded by pain observation forms.

Data will be collected by examining these pain observation forms and diaphragm thickness measurements.

• Study Type: Observational
• Enrollment (Actual): 8

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34722
    • İstanbul medeniyet University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Participants who underwent combined anterior suprascapular nerve block and superficial cervical plexus block in reverse shoulder arthroplasty surgery

Description

Inclusion Criteria:

• Population is defined by database within a given time frame
• Participants who underwent combined anterior suprascapular nerve block and superficial cervical plexus block in reverse shoulder arthroplasty surgery
• Participants aged 18-80
• ASA I-II-III

Exclusion Criteria:

• ASA score > III
• Pediatric individuals under 18 years of age
• Individuals who are pregnant
• Known diaphragmatic paralysis
• Had an allergy or toxicity to local anesthetic agents
• Have an opioid drug allergy

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Group 1; Group 1: Combined Anterior Suprascapular Nerve Block and Superficial Cervical Plexus Block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Change Ratio of Diaphragm Thickness Fraction	Postoperative Change Ratio of Diaphragm Thickness Fraction (%) at Postoperatively 30th. min.	Postoperatively 30th. min.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Assessment with Visual Analogue Scale at postoperatively 30th. Min.	Postoperative VAS score (Ranging from 0-10)	Postoperatively 30th. min
Pain Assessment with Visual Analogue Scale at postoperatively 4th. Hours.	Postoperative VAS score (Ranging from 0-10)	Postoperatively 4th. hour
Pain Assessment with Visual Analogue Scale at postoperatively 6th. Hours.	Postoperative VAS score (Ranging from 0-10)	Postoperatively 6th. hour
Pain Assessment with Visual Analogue Scale at postoperatively 12th. Hours.	Postoperative VAS score (Ranging from 0-10)	Postoperatively 12th. hour
Pain Assessment with Visual Analogue Scale at postoperatively 24th. Hours.	Postoperative VAS score (Ranging from 0-10)	Postoperatively 24th. hour
Opioid Consumption at postoperatively 30th. Min.	Postoperative Opioid Consumption with Morphine PCA (0.5 mg/cc, demand dose 2 cc, lock of time; 10 min. )	Postoperatively 30th. min.
Opioid Consumption at postoperatively 4th. Hours.	Postoperative Opioid Consumption with Morphine PCA (0.5 mg/cc, demand dose 2 cc, lock of time; 10 min. )	Postoperatively 4th. hour
Opioid Consumption at postoperatively 6th. Hours.	Postoperative Opioid Consumption with Morphine PCA (0.5 mg/cc, demand dose 2 cc, lock of time; 10 min. )	Postoperatively 6th. hour
Opioid Consumption at postoperatively 12th. Hours.	Postoperative Opioid Consumption with Morphine PCA (0.5 mg/cc, demand dose 2 cc, lock of time; 10 min. )	Postoperatively 12th. hour
Opioid Consumption at postoperatively 24th. Hours.	Postoperative Opioid Consumption with Morphine PCA (0.5 mg/cc, demand dose 2 cc, lock of time; 10 min. )	Postoperatively 24th. hour

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Satisfaction with 5 point Likert Patient Satisfaction scale at postoperatively 24th. Hours	Postoperative 24th. hour 5 point Likert Patient Satisfaction scale (1-Very dissatisfied, 2 - Dissatisfied, 3 - Unsure, 4 - Satisfied, 5 - Very satisfied)	Postoperatively 24th hour
Postoperative Nausea and Vomiting	Postoperative Nausea and Vomiting Score ( PONV0: No Nausea, No vomiting; PONV1: Nausea present, No vomiting; PONV2: Nausea and vomiting present; PONV3: Vomiting>2 epizodes in 30th. min; PONV4:Vomiting>3 epizodes in 30th.min)	During Postoperatively 24 hour

Collaborators and Investigators

• Sponsor: Istanbul Medeniyet University
• Investigators: Study Director: Ebru Girgin Dinç, İstanbul medeniyet University

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2023
• Primary Completion (Estimated): March 30, 2024
• Study Completion (Estimated): May 30, 2024

Study Registration Dates

• First Submitted: November 17, 2023
• First Submitted That Met QC Criteria: November 17, 2023
• First Posted (Actual): November 24, 2023

Study Record Updates

• Last Update Posted (Estimated): March 6, 2024
• Last Update Submitted That Met QC Criteria: March 3, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: shoulder pain; diaphragmatic paralysis; reverse shoulder replacement; superficial cervical plexus block; anterior suprascapular nerve block
• Additional Relevant MeSH Terms: Nervous System Diseases; Respiratory Tract Diseases; Respiration Disorders; Neurologic Manifestations; Respiratory Insufficiency; Paralysis; Respiratory Paralysis
• Other Study ID Numbers: 2023/0363

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No