View clinical trials related to Interscalene Block.
Filter by:Interscalene brachial plexus block (ISB) is considered the standard nerve block for shoulder surgery . It provides superior analgesia and reduced opioid-related adverse effects . However, it is challenging to perform and may be associated with a high incidence of ipsilateral hemidiaphragmatic paresis, resulting from a phrenic nerve block . Although that complication could be decreased with modified local anesthetic dosing and ultrasound-guided needle placement , its incidence significantly impair the mechanics of breathing leading to postoperative morbidity, making that block undesirable in patients with impaired pulmonary functions . This clinical problem has recently received considerable attention, with several calls to seek alternatives to interscalene block in shoulder arthroscopy [18]. So, the need for a safer ISB alternative has prompted researchers to examine several options, including but not limited to the suprascapular [19] and pericapsular nerve blocks . Pericapsular nerve block has been studied extensively in hip surgeries , and some physicians suggested that it can be safely applied for analgesia and can be part of surgical anesthesia in shoulder arthroscopic surgery. It induces blockade of the articular branches that innervate the glenohumeral joint . The block of this area does not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus . The cervical plexus is formed by the ventral rami of C1-C4 cervical roots. It can be blocked at the superficial, intermediate and at the deep level [24]. The superficial cervical plexus block results in anesthesia of skin over the anterolateral neck, skin overlying the clavicle and the sternoclavicular joint, anterior and retroauricular areas . Although that block is effective in pain management after surgeries involving the distal clavicle, it has been poorly described in shoulder arthroscopy.
Interscalene brachial plexus block is the gold standard for perioperative pain management in shoulder surgery. However, this technique would have side effects and potential serious complications. The aim of this study is to compare between the combination of ultrasound guided suprascapular and supraclavicular nerve blocks versus ultrasound guided interscalene brachial plexus block for post operative analgesia after shoulder instability surgery with latarjet procedure.