SPENG Block Versus Suprascapular and Axillary Nerve Blocks for Pain After Shoulder Arthroscopy (SPENG-RCT)
Analgesic Efficacy of the Shoulder Posterior Pericapsular Nerve Group Block Versus Combined Posterior Suprascapular and Axillary Nerve Blocks for Shoulder Arthroscopy: A Randomized, Blinded, Non-Inferiority Trial
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Murat KAYKAC, MD
- Numer telefonu: +905330258450
- E-mail: drmuratkaykac@gmail.com
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Age 18 to 70 years
- American Society of Anesthesiologists (ASA) physical status I-III
- Scheduled to undergo elective shoulder arthroscopy under general anesthesia
- Able to understand the Numeric Rating Scale for pain assessment
- Able and willing to provide written informed consent
Exclusion Criteria:
- Known allergy or hypersensitivity to local anesthetics used in the study
- Infection at the planned block injection site
- Coagulopathy or ongoing anticoagulant therapy that cannot be appropriately interrupted for peripheral nerve block
- Pre-existing neurological deficit affecting the operative upper extremity
- Moderate or severe pulmonary disease
- Known diaphragmatic dysfunction
- Chronic opioid use
- Chronic pain syndrome
- Body mass index greater than 35 kg/m²
- Pregnancy or breastfeeding
- Inability to understand or reliably report Numeric Rating Scale pain scores
- Inadequate sonographic window preventing safe performance of the allocated block technique before randomization
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Podwójnie
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Eksperymentalny: SPENG Block
Participants assigned to this group will receive an ultrasound-guided Shoulder Posterior Pericapsular Nerve Group (SPENG) block before general anesthesia for shoulder arthroscopy.
A total of 20 mL of 0.25% bupivacaine with epinephrine 1:200,000 will be administered as a single injection between the posterior glenoid rim and the deep surface of the infraspinatus muscle.
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An ultrasound-guided single-injection posterior pericapsular block.
With the participant in the lateral decubitus position and the operative shoulder uppermost, a high-frequency linear ultrasound transducer will be placed transversely immediately inferior to the posterior acromion.
After identification of the humeral head, articular cartilage, infraspinatus muscle, and posterior glenoid rim, a block needle will be advanced in-plane in a medial-to-lateral direction.
The needle tip will be positioned between the posterior glenoid rim and the deep surface of the infraspinatus muscle, and 20 mL of 0.25% bupivacaine with epinephrine 1:200,000 will be injected.
Inne nazwy:
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Aktywny komparator: Posterior Suprascapular and Axillary Nerve Blocks
Participants assigned to this group will receive ultrasound-guided posterior suprascapular and axillary nerve blocks before general anesthesia for shoulder arthroscopy.
A total of 20 mL of 0.25% bupivacaine with epinephrine 1:200,000 will be administered, consisting of 10 mL for the posterior suprascapular nerve block and 10 mL for the axillary nerve block.
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wo ultrasound-guided nerve blocks will be performed.
For the posterior suprascapular nerve block, the suprascapular nerve will be identified in the suprascapular notch region beneath the supraspinatus muscle, and 10 mL of 0.25% bupivacaine with epinephrine 1:200,000 will be administered.
For the axillary nerve block, the posterior humeral circumflex artery will be identified using color Doppler in the quadrilateral space, and 10 mL of 0.25% bupivacaine with epinephrine 1:200,000 will be administered adjacent to the axillary nerve.
Inne nazwy:
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Highest Resting Numeric Rating Scale Pain Score During the First 24 Postoperative Hours
Ramy czasowe: From arrival in the post-anesthesia care unit through 24 hours after surgery
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Resting postoperative pain intensity will be assessed using an 11-point Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain).
For each participant, the highest resting NRS score recorded during the first 24 postoperative hours will be used as the primary outcome.
Scheduled assessments will be performed on arrival in the post-anesthesia care unit and at 4, 8, 12, and 24 hours after surgery.
Resting NRS scores obtained immediately before rescue analgesic administration outside these scheduled assessments will also be included when determining the highest value.
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From arrival in the post-anesthesia care unit through 24 hours after surgery
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Proportion of Participants With Complete Dual-Target Sensory Block Success
Ramy czasowe: 30 minutes after block completion
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Cold sensation will be assessed over the posterior shoulder (suprascapular nerve territory) and lateral deltoid region (axillary nerve territory) using a 3-point scale: 0 = absent sensation, 1 = reduced sensation, and 2 = normal sensation.
Suprascapular sensory component success will be defined as a reduction of at least one grade from baseline in the posterior shoulder region.
Axillary sensory component success will be defined as a reduction of at least one grade from baseline in the lateral deltoid region.
Complete dual-target sensory block success will require successful sensory blockade in both territories in the same participant.
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30 minutes after block completion
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Cumulative Opioid Consumption During the First 24 Postoperative Hours
Ramy czasowe: From arrival in the post-anesthesia care unit through 24 hours after surgery
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All rescue opioid analgesics administered during the first 24 postoperative hours will be recorded and converted to intravenous morphine-equivalent dose for comparison between groups.
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From arrival in the post-anesthesia care unit through 24 hours after surgery
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Time to First Rescue Analgesic
Ramy czasowe: From block completion through 24 hours after surgery
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Time from completion of the study block to the first administration of rescue analgesic medication for postoperative pain.
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From block completion through 24 hours after surgery
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Resting Numeric Rating Scale Pain Scores
Ramy czasowe: On arrival in the post-anesthesia care unit and at 4, 8, 12, and 24 hours after surgery
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Resting pain intensity will be assessed using an 11-point Numeric Rating Scale from 0 (no pain) to 10 (worst imaginable pain).
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On arrival in the post-anesthesia care unit and at 4, 8, 12, and 24 hours after surgery
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Numeric Rating Scale Pain Scores With Movement
Ramy czasowe: On arrival in the post-anesthesia care unit and at 4, 8, 12, and 24 hours after surgery
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Pain intensity during standardized shoulder-related movement will be assessed using an 11-point Numeric Rating Scale from 0 (no pain) to 10 (worst imaginable pain), when clinically feasible.
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On arrival in the post-anesthesia care unit and at 4, 8, 12, and 24 hours after surgery
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Anterior Shoulder Numeric Rating Scale Pain Score
Ramy czasowe: At 8, 12, and 24 hours after surgery
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Pain localized predominantly to the anterior shoulder will be rated separately using an 11-point Numeric Rating Scale ranging from 0 to 10.
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At 8, 12, and 24 hours after surgery
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Posterior Shoulder Numeric Rating Scale Pain Score
Ramy czasowe: At 8, 12, and 24 hours after surgery
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Pain localized predominantly to the posterior shoulder will be rated separately using an 11-point Numeric Rating Scale ranging from 0 to 10.
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At 8, 12, and 24 hours after surgery
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Proportion of Participants With Hemidiaphragmatic Paresis
Ramy czasowe: 30 minutes after block completion
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Diaphragmatic excursion will be assessed using M-mode ultrasonography.
Hemidiaphragmatic paresis will be defined as diaphragmatic excursion 30 minutes after block completion falling to less than 25% of the participant's baseline excursion.
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30 minutes after block completion
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Change in Diaphragmatic Excursion From Baseline
Ramy czasowe: Baseline and 30 minutes after block completion
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Diaphragmatic excursion will be measured using M-mode ultrasonography as the difference in diaphragm position between resting expiration and deep inspiration.
Three measurements will be obtained and averaged.
Change from baseline will be evaluated after the block.
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Baseline and 30 minutes after block completion
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Shoulder Abduction Motor Strength
Ramy czasowe: Baseline, 30 minutes after block completion, and 24 hours after surgery
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Shoulder abduction strength will be evaluated using the Medical Research Council (MRC) scale ranging from 0 to 5, with higher scores indicating greater muscle strength.
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Baseline, 30 minutes after block completion, and 24 hours after surgery
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Proportion of Participants With Rebound Pain
Ramy czasowe: During the first 24 postoperative hours
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Rebound pain will be defined as an increase from an NRS pain score of 3 or lower at the preceding assessment to an NRS score of 7 or higher at the subsequent assessment.
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During the first 24 postoperative hours
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Quality of Recovery-15 Score
Ramy czasowe: 24 hours after surgery
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Postoperative quality of recovery will be assessed using the 15-item Quality of Recovery questionnaire (QoR-15).
The total score ranges from 0 to 150, with higher scores indicating better quality of recovery.
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24 hours after surgery
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Patient Satisfaction With Perioperative Analgesia
Ramy czasowe: 24 hours after surgery
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Overall satisfaction with perioperative analgesia will be rated on an 11-point scale from 0 (completely dissatisfied) to 10 (completely satisfied).
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24 hours after surgery
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Number of Participants With Block-Related Complications
Ramy czasowe: From block performance through postoperative day 7
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Participants will be assessed for block-related adverse events including hematoma, infection, persistent paresthesia, persistent weakness, and other clinically suspected complications.
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From block performance through postoperative day 7
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Block Performance Time
Ramy czasowe: Periprocedural
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Time required to perform the allocated regional anesthesia technique, measured in seconds from the first contact of the ultrasound transducer with the skin until removal of the block needle after completion of local anesthetic injection.
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Periprocedural
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Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Murat KAYKAC, MD, İzmir City Hospital
- Dyrektor Studium: Derya ARSLAN YURTLU, Professor, İzmir City Hospital
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- SPENG-RCT-2026-01
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
- ANALITYCZNY_KOD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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