Interscalene Versus Infraspinatus-Teres Minor Blocks for Arthroscopic Shoulder Surgery
NCT ID: NCT07253740
Last Updated: 2026-01-05
Study Results
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Basic Information
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RECRUITING
NA
60 participants
INTERVENTIONAL
2026-01-01
2026-05-02
Brief Summary
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Detailed Description
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This study aims to determine whether the ITM block provides comparable perioperative analgesia to the ISB block while potentially reducing hemidiaphragmatic paresis and pulmonary compromise.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Interscalene Brachial Plexus Block (ISB)
Patients will receive ISB under ultrasound guidance prior to arthroscopic shoulder surgery using 15 ml 0.25% bupivacaine.
Interscalene Brachial Plexus Block (ISB)
Patients receive ultrasound-guided ISB before arthroscopic shoulder surgery. After sedation with IV midazolam, 15 ml of 0.25% bupivacaine is injected using a 22 Gauge 50 mm needle with posterior in-plane approach, targeting C5-C6 roots.
Infraspinatus-Teres Minor Block (ITM)
Patients will receive TM block under ultrasound guidance using 25 ml 0.25% bupivacaine between infraspinatus and teres minor muscles.
Infraspinatus-Teres Minor Block (ITM)
Patients receive ultrasound-guided ITM interfascial block in sitting position before surgery. Using a 22 Gauge 10 mm needle, 25 ml of 0.25% bupivacaine is injected between infraspinatus and teres minor muscles via out-of-plane or in-plane hydrodissection.
Interventions
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Interscalene Brachial Plexus Block (ISB)
Patients receive ultrasound-guided ISB before arthroscopic shoulder surgery. After sedation with IV midazolam, 15 ml of 0.25% bupivacaine is injected using a 22 Gauge 50 mm needle with posterior in-plane approach, targeting C5-C6 roots.
Infraspinatus-Teres Minor Block (ITM)
Patients receive ultrasound-guided ITM interfascial block in sitting position before surgery. Using a 22 Gauge 10 mm needle, 25 ml of 0.25% bupivacaine is injected between infraspinatus and teres minor muscles via out-of-plane or in-plane hydrodissection.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Scheduled for elective unilateral arthroscopic shoulder surgery
* Provide written informed consent
Exclusion Criteria
* Allergy to study drugs
* Severe cardiac, renal, or hepatic disease
* Neurological deficit or neuropathy
* Anticoagulant therapy
* Pre-existing respiratory dysfunction
* Chronic shoulder pain or planned open surgery
18 Years
65 Years
ALL
No
Sponsors
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Ataturk University
OTHER
Responsible Party
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Ali Ahiskalioglu
Principal Investigator Ali Ahıskalıoğlu
Principal Investigators
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Ali Ahıskalıoğlu, Professor
Role: PRINCIPAL_INVESTIGATOR
Ataturk University Department of Anesthesiology and Reanimation
Locations
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Ataturk University
Erzurum, , Turkey (Türkiye)
Countries
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Central Contacts
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Facility Contacts
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References
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Renes SH, Rettig HC, Gielen MJ, Wilder-Smith OH, van Geffen GJ. Ultrasound-guided low-dose interscalene brachial plexus block reduces the incidence of hemidiaphragmatic paresis. Reg Anesth Pain Med. 2009 Sep-Oct;34(5):498-502. doi: 10.1097/AAP.0b013e3181b49256.
Kim SH, Yeo IS, Jang J, Jung HE, Chun YM, Yang HM. Infraspinatus-teres minor (ITM) interfascial block: a novel approach for combined suprascapular and axillary nerve block. Reg Anesth Pain Med. 2024 Jan 11;49(1):67-72. doi: 10.1136/rapm-2023-104738.
Kang R, Jeong JS, Chin KJ, Yoo JC, Lee JH, Choi SJ, Gwak MS, Hahm TS, Ko JS. Superior Trunk Block Provides Noninferior Analgesia Compared with Interscalene Brachial Plexus Block in Arthroscopic Shoulder Surgery. Anesthesiology. 2019 Dec;131(6):1316-1326. doi: 10.1097/ALN.0000000000002919.
Teske LG, Pill SG, Lutz A, Thigpen CA, Shanley E, Adams KJ, Bohon H, Graham GD, Marston G, Walker KB, Kissenberth MJ. Single shot interscalene regional anesthesia provides noninferior analgesia and decreased complications compared with an indwelling catheter for arthroscopic and reconstructive shoulder surgery. J Shoulder Elbow Surg. 2022 Jun;31(6S):S152-S157. doi: 10.1016/j.jse.2022.02.004. Epub 2022 Mar 15.
Benyamin R, Trescot AM, Datta S, Buenaventura R, Adlaka R, Sehgal N, Glaser SE, Vallejo R. Opioid complications and side effects. Pain Physician. 2008 Mar;11(2 Suppl):S105-20.
Luan H, Hao C, Li H, Zhang X, Zhao Z, Zhu P. Effect of interscalene brachial plexus block with dexmedetomidine and ropivacaine on postoperative analgesia in patients undergoing arthroscopic shoulder surgery: a randomized controlled clinical trial. Trials. 2023 Jun 12;24(1):392. doi: 10.1186/s13063-023-07292-2.
Ahiskalioglu A, Karapinar YE, Dagci Y, Yayik AM, Ciftci B, Tulgar S. An alternative sonographic approach to infraspinatus-teres minor interfascial plane block: make it easy. Minerva Anestesiol. 2025 Apr;91(4):359-361. doi: 10.23736/S0375-9393.24.18697-X. Epub 2025 Feb 6. No abstract available.
Other Identifiers
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ATAUNISHOULDER
Identifier Type: -
Identifier Source: org_study_id
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