Shoulder Anterior Capsule Block Combined With Supra Scapular Nerve Versus Interscalene Block as Sole Anesthesia in Shoulder Arthroscopy
Shoulder Anterior Capsule Block Combined With Suprascapular Nerve Block Versus Interscalene Block as a Sole Anesthetic Technique for Shoulder Arthroscopy
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Ultrasonographic peripheral nerve block has been a popular technique not only for pain management but also for surgical anesthesia especially in patients with comorbidities, avoiding complications associated with general anesthesia (airway-difficulties, hemodynamic instability, etc.) and ensuring excellent pain control, reducing peri-operative consumption of opioids and their side effects, and improving patient satisfaction.
Interscalene block (ISB) is the gold stander anesthetic technique for shoulder surgeries but hemi-diaphragmatic paralysis still problematic. The SHAC is the combination of two different blocks. The first block is the inter fascial space between the deep layer of the deltoid fascia and the superficial layer of the subscapularis fascia, anterior to the subscapularis myotendinous junction. This inter fascial space, we can reach both the axillary nerve and the subscapular nerves, the lateral pectoral nerve, and the musculocutaneous nerve results in achieving adequate anesthesia and analgesia without phrenic nerve affection.
The present study will be conducted to compare of SHAC block combined with suprascapular nerve block and Interscalene block as an anesthetic option in shoulder arthroscopic surgery may allow adequate postoperative analgesia and decrease the overall opioid usage and enhanced patient recovery
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Sharqia Province
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Zagazig, Sharqia Province, Egypte
- Zagazig University Hospitals
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Written informed consent from patients.
- BMI less than or equal 30 kgm .
- Age 18-75 years old.
- ASA class I, II and III.
Exclusion Criteria:
- Allergy to local anesthetics.
- Infection at site of injection.
- Patients with coagulopathy.
- Physical and mental disease which could interfere with pain scores evaluation.
- pre-existing neuropathy of the operative limb.
- Pre-existing sever pulmonary diseases (obstructive or restrictive).
- Patients with distorted local anatomy.
Patients with chronic pain syndrom
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Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Autre
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: Group SHAC block
Group SHAC block: Patients will receive Ultrasound Guided Shoulder Anterior Capsule block and Suprascapular nerve block
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Group SHAC block: Patients will receive Ultrasound Guided Shoulder Anterior Capsule block and Suprascapular nerve block
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Comparateur actif: Group IS block
Group IS block: Patients will receive Ultrasound Guided interscalene brachial plexus block.
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Group IS block: Patients will receive Ultrasound Guided interscalene brachial plexus block.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by using Visual Analogue Scale (VAS)
Délai: From start of surgery and for the 1st 24 hours postoperatively.
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Inter-operative VAS immediately after the block and every 5 minutes for 30 minutes and every 2 hours post-operatively for 24 hours while 0 indicates no pain and 10 the severest pain.
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From start of surgery and for the 1st 24 hours postoperatively.
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Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by duration of analgesia
Délai: 24 hours postoperatively
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Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by duration of analgesia.
Duration of postoperative analgesia (from the time of patient recovery till the time of rescue analgesia).
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24 hours postoperatively
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Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by amount of opioid consumption postoperatively.
Délai: 1st 24 hours postoperatively.
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Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by amount of opioid consumption postoperatively.
Total dose of morphine per mg used during the 1st 24 hours postoperatively.
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1st 24 hours postoperatively.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Safety of SHAC block by monitoring of complications eg. local anesthetic toxicity , hemodynamics instability, phrenic nerve affection, pneumothorax.
Délai: From start of surgery and for the 1st 24 hours.
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Monitoring of complications like local anesthetic toxicity ( restlessness, irritability, confusion, convulsions and arrhythmias) hemodynamics instability, phrenic nerve affection ( diaphragmatic paralysis) , pneumothorax ( decrease in oxygen saturation monitoring, tachypnea, diminished air entry on affected side by auscultation).
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From start of surgery and for the 1st 24 hours.
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Patient satisfaction with the anesthesia and analgesia during and after surgery
Délai: From start of surgery and for the 1st 24 hours postoperatively.
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Patient satisfaction was evaluated by using satisfaction score and patients were graded on a 5-point scale: 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, 5 = very satisfied, and assessed at 24 h post-operation
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From start of surgery and for the 1st 24 hours postoperatively.
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 387/10 - june-2024
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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