Combined Suprascapular and Axillary Nerve Blocks for Arthroscopic Shoulder Surgery

Arthroscopic Shoulder Surgery Clinical Trial

Official title:

Combined Suprascapular and Axillary Nerve Blocks for Sevoflurane Consumption and Postoperative Analgesia in Arthroscopic Shoulder Surgery

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03212443
• Other study ID #: Diskapi4
• Status: Completed
• Phase: N/A
• Start date: August 10, 2017
• Est. completion date: March 22, 2018

Study information

• Verified date: August 2018
• Source: Diskapi Teaching and Research Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Arthroscopic shoulder surgery is associated with severe pain postoperatively. Regional nerve block adding to general anesthesia might improve the quality of postoperative analgesia. The aim of the study is to compare the subacromial local anesthetic infiltration and the suprascapular-axillary nerve blocks combination for intraoperative sevoflurane consumption, postoperative analgesia and analgesic consumption.

Description:

After informed consent and with ethics approval, 60 ASA 2-3 patients scheduled for elective arthroscopic shoulder surgery will be included in this study. Patient will be divided to two groups by using computer -generated list for randomization. In group A, the surgeon will apply 20 ml of 0.250% bupivacaine to the subacromial region at the end of the procedure. In Group B, suprascapular (10 ml of 0.250% bupivacaine ) and axillary block (10 ml of 0.250% bupivacaine) will be performed with ultrasound and nerve stimulator guidance before induction of anesthesia. In all patients after standard and BIS (Bi spectral index) monitorization general anesthesia will be induced with remifentanil (10mcg iv), propofol (2.5 mg/kg iv) and rocuronium (0.5mg/kg iv). After intubation, anesthesia will be maintained with 50% O2 and N2O mixture. Hemodynamic parameters, BIS values, end-tidal sevoflurane consumption will be recorded by blind investigator. Postoperative visual analog scale (VAS) values, postoperative analgesic consumption (Tramadol, patient controlled analgesia), complications will be recorded.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 46
• Est. completion date: March 22, 2018
• Est. primary completion date: February 25, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• American society of anesthesia physical status (ASA) 1,2 patients

• Elective arthroscopic shoulder surgery

Exclusion Criteria:

• ASA 3,4 patients

• Coagulation abnormality

• Body mass index >30

• Preexisting neurological deficit Local anesthetic allergy history Diabetes

Related Conditions & MeSH terms

• Arthroscopic Shoulder Surgery
• Axillary Nerve Block
• Suprascapular Nerve Block

Intervention

Procedure:
• Suprascapular nerve- axillary nerve block combination
In Group B, suprascapular (10 ml of 0.250% bupivacaine ) and axillary block (10 ml of 0.250% bupivacaine) will be performed with ultrasound and nerve stimulator guidance before induction of anesthesia
• Subacromial infiltration
In group A, the surgeon will apply 20 ml of 0.250% bupivacaine to the subacromial region at the end of the procedure

Locations

Country	Name	City	State
Turkey	Derya Ozkan	Ankara

Sponsors (1)

Lead Sponsor	Collaborator
Diskapi Teaching and Research Hospital

Country where clinical trial is conducted

Turkey, 

References & Publications (2)

Dhir S, Sondekoppam RV, Sharma R, Ganapathy S, Athwal GS. A Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery: An Equivalence Study. Reg Anesth Pain Med. 2016 Sep-Oct; — View Citation

Ritchie ED, Tong D, Chung F, Norris AM, Miniaci A, Vairavanathan SD. Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality? Anesth Analg. 1997 Jun;84(6):1306-12. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Bleeding assesment	stage1: Good surgical visualization (numeric rating scale 7<), Stage 2: Moderate bleeding (numeric rating sacle =4-7), Stage 3: Severe bleeding, bad surgical visualization (numeric rating scale < 4)	5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia
Primary	Postoperative VAS scores	Ranging from 0: no pain to 10: worst pain	Through postoperative period, an avarage of 30 minutes
Secondary	sevoflurane consumption	End tidal sevoflurane concentration values assesment during the surgery	5th, 10th,20th,30th,40th,50th minutes after induction of anesthesia