A Comparison of ESP Block to SSN Block for Analgesia in Shoulder Surgery

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

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-20

Study Completion Date

2021-11-10

Brief Summary

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A comparison between Erector Spinae Plane block and Suprascapular nerve block in providing analgesia for shoulder surgery

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Detailed Description

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Suprascapular nerve block is considered a phrenic nerve sparing approach that recently introduced as alternative for interscalene brachial plexus nerve block in shoulder surgery. However, some researchers reported that Suprascapular nerve block alone results in an ineffective analgesia. Erector Spinae Plane block is supposed to be able in providing adequate analgesia in shoulder surgery

Conditions

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Arthroscopic Shoulder Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

There has been a recent renewed interest in using the suprascapular nerve block (SSNB) as a phrenic nerve sparing approach for analgesia after shoulder surgery. The suprascapular nerve provides 70% of the sensory input to the glenohumeral joint and also innervates the infraspinatus and supraspinatus muscles. However, some researchers suggest that SSNB alone cannot provide a sufficient analgesia.The high-thoracic erector spinae plane block (HT-ESPB) has been described in several case reports as an effective analgesic modality for the shoulder region without causing motor or phrenic nerve block

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

The care provider and outcome assessor will be unaware of the study design

Study Groups

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The block group (a)

Patients were randomized in a 1:1 :1ratio, group (a) will receive SSN. The nerve blocks The procedure will be performed after induction of anaesthesia and endotracheal intubation.

Group Type EXPERIMENTAL

Block procedures for shoulder surgery analgesia

Intervention Type OTHER

The patients in group (a) will be placed in lateral decubitus. Then, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used to locate the transverse process of T2, where a needle will be inserted in a cephalocaudal direction until reaching the space between the fascia of the erector spinae and the transverse process of T2 and 30 ml of local anesthetic of bupivacaine 0.5% will be injected.

* In group (b), SSC nerve block will be done as follow: In the suprascapular notch, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used. The linear probe, enveloped in a sterile sheath, will be placed parallel to the spine of the scapula to visualize it and then will be moved cephalic to the supraspinatus fossa. The probe will then be moved laterally up to the scapular notch, where the nerve will be identified by its round hyperechogenic shape 4 cm deep.
* control group: patients will receive only general anesthesia

The block group (b)

Patients were randomized in a 1:1:1 ratio. group (b) will receive the Erector spinae plane block. The procedure will be performed after induction of anesthesia and endotracheal intubation.

Group Type EXPERIMENTAL

Block procedures for shoulder surgery analgesia

Intervention Type OTHER

The patients in group (a) will be placed in lateral decubitus. Then, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used to locate the transverse process of T2, where a needle will be inserted in a cephalocaudal direction until reaching the space between the fascia of the erector spinae and the transverse process of T2 and 30 ml of local anesthetic of bupivacaine 0.5% will be injected.

* In group (b), SSC nerve block will be done as follow: In the suprascapular notch, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used. The linear probe, enveloped in a sterile sheath, will be placed parallel to the spine of the scapula to visualize it and then will be moved cephalic to the supraspinatus fossa. The probe will then be moved laterally up to the scapular notch, where the nerve will be identified by its round hyperechogenic shape 4 cm deep.
* control group: patients will receive only general anesthesia

control group

Patients were randomized in a 1:1:1 ratio. this group will receive general anesthesia (GA) only

Group Type PLACEBO_COMPARATOR

Block procedures for shoulder surgery analgesia

Intervention Type OTHER

The patients in group (a) will be placed in lateral decubitus. Then, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used to locate the transverse process of T2, where a needle will be inserted in a cephalocaudal direction until reaching the space between the fascia of the erector spinae and the transverse process of T2 and 30 ml of local anesthetic of bupivacaine 0.5% will be injected.

* In group (b), SSC nerve block will be done as follow: In the suprascapular notch, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used. The linear probe, enveloped in a sterile sheath, will be placed parallel to the spine of the scapula to visualize it and then will be moved cephalic to the supraspinatus fossa. The probe will then be moved laterally up to the scapular notch, where the nerve will be identified by its round hyperechogenic shape 4 cm deep.
* control group: patients will receive only general anesthesia

Interventions

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Block procedures for shoulder surgery analgesia

The patients in group (a) will be placed in lateral decubitus. Then, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used to locate the transverse process of T2, where a needle will be inserted in a cephalocaudal direction until reaching the space between the fascia of the erector spinae and the transverse process of T2 and 30 ml of local anesthetic of bupivacaine 0.5% will be injected.

* In group (b), SSC nerve block will be done as follow: In the suprascapular notch, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used. The linear probe, enveloped in a sterile sheath, will be placed parallel to the spine of the scapula to visualize it and then will be moved cephalic to the supraspinatus fossa. The probe will then be moved laterally up to the scapular notch, where the nerve will be identified by its round hyperechogenic shape 4 cm deep.
* control group: patients will receive only general anesthesia

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ASA I and II,
* Age above 21 years and below 60 years in both sexes,
* Cooperative patients,
* Patients with a BMI (body mass index) not exceeding 35.

Exclusion Criteria

* patients with cardiovascular or respiratory compromise,
* Patient refusal,
* Coagulopathy,
* Local tissue infection,
* Allergy to local anesthesia,
* prior to cervical or thoracic spine surgery.

Minimum Eligible Age

21 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No