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Diaphragmatic Paralysis After Ultrasound Block of the Suprascapular Nerve for Shoulder Surgery

NCT ID: NCT03352687

Last Updated: 2025-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-02

Study Completion Date

2019-02-28

Brief Summary

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Shoulder surgery is a source of intense postoperative pain that justifies the use of opioids. In this context, analgesia provided by locoregional anesthesia (ALR) improves the rehabilitation of patients by reducing the length of hospital stay and morphine consumption. Thus anesthesia of the brachial plexus interscalene (interscalene block or BIS) is considered as the reference technique for the management of post-operative pain after shoulder surgery. It is however provider of hemi-diaphragmatic paralysis (PhD) in nearly 100% of cases. Thus, this technique is usually avoided in patients with respiratory insufficiency. In arthroscopic shoulder surgery, the development of a suprascapular and axillary nerve (SSAX) conjugate block appears to be an effective analgesic alternative in this context.

Detailed Description

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Two ultrasound-guided approaches of the suprascapular nerve (anterior and posterior approaches) have been described in the literature. From an anatomical point of view, the anterior approach could expose patients to the risk of ipsilateral PhD by phrenic nerve block secondary to diffusion of the local anesthetic into the supraclavicular region.

By measuring the diaphragm excursion during a sniff test, ultrasound allows reliable and reproducible analysis of the diaphragm function.

No study has evaluated the incidence of PhD after ultrasound block of the suprascapular nerve. Knowing the influence of the approach on this complication could be of major interest in this context.

Conditions

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Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Anterior SSAX

patients receiving suprascapular and axillary nerve block (SSAX) whose approach to the SS nerve is performed by anterior route

Group Type EXPERIMENTAL

anterior SSAX

Intervention Type PROCEDURE

block of the suprascapular nerve block for shoulder surgery by anterior way

Posterior SSAX

patients receiving suprascapular and axillary nerve block (SSAX) whose approach to the SS nerve is performed by posterior route

Group Type EXPERIMENTAL

posterior SSAX

Intervention Type PROCEDURE

block of the suprascapular nerve block for shoulder surgery by posterior way

Interventions

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anterior SSAX

block of the suprascapular nerve block for shoulder surgery by anterior way

Intervention Type PROCEDURE

posterior SSAX

block of the suprascapular nerve block for shoulder surgery by posterior way

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* to benefit from scheduled arthroscopic surgery of the shoulder under general anesthesia
* Affiliate or beneficiary of a social security scheme
* Having signed the informed consent

Exclusion Criteria

* the existence of contralateral diaphragmatic paralysis
* pre-existing respiratory insufficiency
* impossibility of performing diaphragmatic ultrasound
* the patient's refusal
* the existence of major spontaneous or acquired haemostatic disorders
* an infection at the point of puncture
* allergy to local anesthetics
* Pregnant or likely to be pregnant
* Patients under protection of the adults (guardianship, curators or safeguard of justice)
* Patients whose cognitive state does not allow assessment by the scales used
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Toulouse

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fabrice FERRE, MD PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Toulouse

Locations

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University Hospital

Toulouse, , France

Site Status

Countries

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France

References

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Ferre F, Pommier M, Laumonerie P, Ferrier A, Menut R, Bosch L, Balech V, Bonnevialle N, Minville V. Hemidiaphragmatic paralysis following ultrasound-guided anterior vs. posterior suprascapular nerve block: a double-blind, randomised control trial. Anaesthesia. 2020 Apr;75(4):499-508. doi: 10.1111/anae.14978. Epub 2020 Jan 26.

Reference Type RESULT
PMID: 31984478 (View on PubMed)

Other Identifiers

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2017-A01378-45

Identifier Type: REGISTRY

Identifier Source: secondary_id

RC31/17/0141

Identifier Type: -

Identifier Source: org_study_id