Anterior Glenoid Nerve Block Versus Pericapsular Nerve Group Block Versus Interscalene Brachial Plexus Block for Postoperative Pain Management in Shoulder Arthroscopic Surgeries

Anterior Glenoid Nerve Block Versus Pericapsular Nerve Group (PENG) Block Versus Interscalene Brachial Plexus (ISB) Block for Postoperative Pain Management in Shoulder Arthroscopic Surgeries

This study aims to compare between Anterior glenoid nerve block, pericapsular nerve group (PENG) block and Interscalene brachial plexus (ISB) block for post-operative pain management in shoulder arthroscopic surgeries

Study Overview

• Status: Recruiting
• Conditions: Postoperative Pain; Interscalene Brachial Plexus Block; Pericapsular Nerve Group Block; Anterior Glenoid Nerve Block; Shoulder Arthroscopic Surgeries
• Intervention / Treatment: Other: Interscalene brachial plexus block; Other: Anterior glenoid nerve block; Other: Pericapsular nerve group block

Detailed Description

Major surgeries of the shoulder constitute some of the most commonly performed orthopedic procedures. They often result in moderate to severe postoperative pain thereby requiring a multimodal analgesic approach centered around peripheral nerve blocks.

Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay.

Interscalene blocks (ISB) are well-studied and established means of providing analgesia following shoulder surgery and are considered the gold standard mode of regional anesthesia and post-operative pain management in shoulder surgeries.

A novel technique: pericapsular nerve group (PENG) block can be effectively and safely applied under ultrasound guidance in shoulder surgery cases for postoperative analgesia. In addition, PENG block targets articular branches with less motor effect compared with interscalene brachial plexus block providing anesthetic and analgesic effect with less complication and better and sooner ambulation.

• Study Type: Interventional
• Enrollment (Estimated): 49
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mohamed Serry, Master; Phone Number: 00201002609476; Email: mohamed.serry@med.asu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt, 11591
    • Recruiting
    • Ain Shams University
    • Sub-Investigator: Amr E Abd El-Hamid, MD
    • Sub-Investigator: Ihab H Attia, MD
    • Sub-Investigator: Amr H Ali, MD
    • Sub-Investigator: Ossama M Farrag, MD
    • Contact: Mohamed Serry, Master; Phone Number: 00201002609476; Email: mohamed.serry@med.asu.edu.eg

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age from 18 to 70 years.
• No sex predilection.
• American Society of Anesthesiology (ASA) physical status I-II.
• Undergoing shoulder arthroscopic surgeries.

Exclusion Criteria:

• Patient's refusal.
• Patients with a history of drug allergies to study drugs.
• Evidence of local infection at the site of injection.
• Inability to cooperate
• Neuromuscular pathology (example: - Multiple Sclerosis)
• Previous trauma or surgery to the shoulder

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Interscalene brachial plexus block group; Patients will receive an Interscalene brachial plexus block.	Other: Interscalene brachial plexus block; Patients will receive an Interscalene brachial plexus block.
Experimental: Anterior glenoid nerve block group; Patients will receive an anterior glenoid nerve block.	Other: Anterior glenoid nerve block; Patients will receive an anterior glenoid nerve block.
Experimental: Pericapsular nerve group (PENG) block group; Patients will receive a pericapsular nerve group (PENG) block.	Other: Pericapsular nerve group block; Patients will receive a pericapsular nerve group (PENG) block.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to the 1st rescue analgesia	Time to the first request for the rescue analgesia (time from the end of surgery to the first dose of pethidine administrated).	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total pethidine consumption	All patients will receive intravenous pethidine (30mg) on demand [Visual Analogue Scale (VAS) score ≥3].	24 hours postoperatively
Degree of pain	Degree of pain will be assessed using visual analogue scale (VAS). Each patient will be instructed about postoperative pain assessment with the VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at 0, 6, 12, and 24 hours postoperatively.	24 hours postoperatively
Length of hospital stay	Length of hospital stay will be recorded from admission till the discharge from hospital.	Till discharge from hospital (Up to one week).
Time needed for the patient to freely move the operated limb	Time needed for the patient to freely move the operated limb will be recorded.	Postoperatively (Up to one week).
Degree of patients satisfaction	Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): January 13, 2025
• Primary Completion (Estimated): June 1, 2025
• Study Completion (Estimated): June 1, 2025

Study Registration Dates

• First Submitted: December 31, 2024
• First Submitted That Met QC Criteria: January 8, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 13, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pain, Postoperative
• Other Study ID Numbers: FMASU MD195/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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