Postoperative Pain Clinical Trial
Official title:
Evaluating the Effectiveness of Cervical Erector Spinae Block for Shoulder Surgery
Arthroscopic shoulder surgery is often associated with moderate to severe postoperative pain
that may interfere with patients' early mobilization, recovery and quality of life.
In addition, by using an effective analgesic technique, a patient may experience less nausea,
vomiting and drowsiness after surgery that are associated with the use of opioids to manage
postoperative pain. Erector spinae plane block (ESPB) has been used in many different
indications for acute pain treatment at different thoracic and lumbar levels. Recently,
staining the roots of the brachial plexus has been reported in a cadaveric study of the
cervical ESPB (1).
However, there are only few case reports related to efficiency and safety of this newly
defined cervical ESPB technique (2) .
The primary objective of this randomized controlled is investigate the post-operative
analgesic effectiveness of ultrasound guided single-shot cervical ESPB for patients
undergoing arthroscopic shoulder surgery in comparison to those receiving conventional
parentheral opioid analgesia alone.
Secondary objective is testing the safety of this newly defined block in terms of incidence
of complications.
60 patients will be enrolled to in this study between June 2020 - October 2020. All patient
will be randomly selected who will be operated for shoulder surgery. Age, weight, ASA score,
body mass index, additional dissease status will be recorded. The patients will be divided in
two groups. One group will have cervical ESPB before the operation and the second group will
be treated with multimodal analgesia techniques and both groups will receive patient
controlled analgesia.
Both groups will receive identical anaethesia protocols. Perioperative analgesia protocols
will provide acetaminophen 1 gr and the same dose will be repeated in every 6 hours
regardless of the pain scores. In postoperative period, the pain scores of the patients will
be recorded according to the numeric rating scale (NRS) in every three hours. If pain score
raises over 3/10 on NRS the patient will receive tramadol 100mg as rescue analgesia. In case
of persisting pain first, meperidine 50 mg will be applied and other multimodal analgesic
drugs will be added to protocol. At the end of the study 24 hours total opioid usage of
patients, pain scores and side effects will statistically be analyzed.
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