Erector Spinae Plane Block Versus Infraspinatus-Teres Minor Interfascial Plane Block for Analgesia After Shoulder Arthroscopy

July 2, 2026 updated by: Canberk Çetinel, Taksim Egitim ve Arastirma Hastanesi

Novel Analgesic Approaches in Shoulder Surgery: Erector Spinae Plane Block Versus Infraspinatus-Teres Minor Interfascial Plane Block

The shoulder, being an anatomical region innervated by different nerves, has a wide variety of analgesic approaches, which differ depending on the practitioner. New approaches are being developed based on the different innervation channels demonstrated in clinical and cadaver studies. Over time, the effectiveness of axillary block, suprascapular block, interscalene block, local infiltration, and various combinations, as well as non-regional methods, has been observed. The goal of these approaches is to achieve the highest possible level of patient comfort, high analgesic efficacy, and minimal complications. Studies have shown that the interscalene block has the highest analgesic efficacy and the most ideal postoperative results; therefore, it is frequently used as the gold standard in this field. Providing effective analgesia with a single intervention can also be cited as an aspect that increases patient comfort and simplifies the procedure. In interscalene block; unilateral transient diaphragmatic paralysis due to the spread of local anesthetics to the C7 nerve root, respiratory problems and potential spinal/epidural complications, new approaches are being followed and researched. Results from cervical/high thoracic erector spinae plane block (ESPB) and infraspinatus-teres minor interfascial plane block (ITMIPB) studies, which are the subject of new studies, strengthen the hypothesis that they provide effective analgesia. Neither of these blocks, performed with ultrasonography, carries the risks present in interscalene block. Although the usual risks of a peripheral nerve block are present for these procedures; the block sites are considered safer due to its distance from vascular structures and the reduced risk of additional complications. While small sample studies exist for each type of block, no studies comparing their effectiveness have been found. Besides reduced complications, another advantage of these two blocks is their ability to provide effective analgesia with a single-point injection. The aim of this study is to compare the analgesic efficacy of Cervical Erector Spine Plane Block (ESP) and Infraspinatus-Teres Minor Interfascial Plane Block (ITMIPB) applied for postoperative analgesia in ASA I-III patients undergoing shoulder surgery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
    • Beyoğlu
      • Istanbul, Beyoğlu, Turkey (Türkiye), 34433
        • Taksim Educational and Research Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults scheduled for elective shoulder arthroscopy
  • ASA I-II-III patients
  • Patients age between 18-80

Exclusion Criteria:

  • Patients with previously known allergy to local anesthetics.
  • Patients with insufficient pulmonary functions (Severe obstruction or restriction in Pulmonary Function Test)
  • Patients with ASA IV or higher
  • Patients who suffered from any complications related to anesthesia or surgery
  • Patients with additional body part injury
  • Pregnant or breastfeeding women

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Erector Spinae Plane Block Group
Patients receiving ultrasound-guided cervical erector spinae plane block for postoperative analgesia.
Procedure: cervical erector spinae plane block
Before shoulder surgery, Ultrasound-guided C8-T1 ESP block will be performed for postoperative analgesia
Drug: Bupivacaine %0.25 (isobaric)
In the both groups, peripheral nerve blocks are performed by using Bupivacaine %0,25.
Active Comparator: Infraspinatus Teres Minor Interfascial Plane Block Group
Patients receiving ultrasound-guided Infraspinatus Teres Minor Interfascial Plane Block for postoperative analgesia.
Drug: Bupivacaine %0.25 (isobaric)
In the both groups, peripheral nerve blocks are performed by using Bupivacaine %0,25.
Procedure: Infraspinatus Teres Minor Interfascial Plane Block
Before surgery, Ultrasound-guided Infraspinatus Teres Minor Interfascial Plane Block will be performed for postoperative analgesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity
Time Frame: Postoperative 1., 6., 12. and 24. hour
Pain intensity assessed using the 11-point Numeric Rating Scale (NRS; 0=no pain, 10=worst imaginable pain).
Postoperative 1., 6., 12. and 24. hour

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total postoperative analgesic consumption
Time Frame: 24 hours after surgery
Total amount of rescue analgesics (NSAIDs, paracetamol, and opioids) administered during the first 24 hours after surgery. Opioid consumption will be converted to intravenous morphine equivalents for analysis, when applicable.
24 hours after surgery
Incidence of postoperative nausea and vomiting (PONV)
Time Frame: 24 hours after surgery
Occurrence of postoperative nausea and/or vomiting requiring treatment during the first 24 hours after surgery. Also, the need for rescue antiemetic medication will be recorded.
24 hours after surgery
Block-related complications
Time Frame: 24 hours after surgery
Incidence of block-related complications, including local anesthetic systemic toxicity, vascular puncture, hematoma, infection, pneumothorax, persistent sensory or motor deficits, and other procedure-related adverse events.
24 hours after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Taksim Egitim ve Arastirma Hastanesi

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

July 1, 2027

Study Completion (Estimated)

July 1, 2027

Study Registration Dates

First Submitted

June 27, 2026

First Submitted That Met QC Criteria

July 2, 2026

First Posted (Actual)

July 7, 2026

Study Record Updates

Last Update Posted (Actual)

July 7, 2026

Last Update Submitted That Met QC Criteria

July 2, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2024-KAEK-12

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Time Frame

Beginning 6 months following publication and ending 5 years after publication.

IPD Sharing Access Criteria

Individual participant data will be available to qualified researchers upon reasonable request to the principal investigator. Requests will be evaluated based on scientific merit and ethical considerations.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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