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
調査の概要
状態
詳細な説明
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
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Sharqia Province
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Zagazig、Sharqia Province、エジプト
- Zagazig University Hospitals
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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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研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：他の
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ：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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アクティブコンパレータ：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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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Assessment of SHAC block efficacy for postoperative analgesia in shoulder arthroscopic surgeries by using Visual Analogue Scale (VAS)
時間枠：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
時間枠：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.
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Safety of SHAC block by monitoring of complications eg. local anesthetic toxicity , hemodynamics instability, phrenic nerve affection, pneumothorax.
時間枠：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
時間枠：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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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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