Postoperative Analgesia of Magnesium Sulfate in Suprascapular Nerve Block Following Shoulder Arthroscopy

Summary

* Arthroscopic shoulder surgeries in adults are accompanied with severe immediate postoperative pain reported in approximately 45% of patients. For quicker recovery and rehabilitation of these patients, postoperative analgesia is mandatory.
* Different analgesic modalities have been proposed including parenteral opioids, intra-articular injection of local anesthetics, interscalene brachial plexus block (ISB), and a suprascapular nerve block (SSNB), with varying degrees of effectiveness and multiple reported side effects.
* A recent meta-analysis demonstrates that suprascapular block results in 24-h morphine consumption and pain scores similar to ISB, so, it may be considered an effective and safe alternative for interscalene block in shoulder surgery, with less motor restriction, and fewer complications.
* Different agents are used as adjuvants to local anesthetics during peripheral nerve block to prolong its analgesic action including magnesium sulfate.
* A meta-analysis by Mengzhu et al., concluded that magnesium sulfate combined with local anesthetics in perineural nerve blocks provided better analgesic efficacy and may be a promising analgesic for perineural nerve blocks.
* Antinociceptive effects of magnesium are due to the regulation of calcium influx into the cell and a non-competitive antagonism of the NMDA receptors

Conditions

• Arthroscopic Shoulder Surgery

Interventions

DRUG

Bupivacaine

Ultrasound-guided suprascapular nerve block will be performed using 7 mL of 0.5% bupivacaine plus 3 mL of 0.9% saline

DRUG

Bupivacaine-magnesium

Ultrasound-guided suprascapular nerve block will be performed using 7 mL of 0.5% bupivacaine plus magnesium sulfate 10% (3 ml) (total 10mL)

DRUG

Propofol

Using propofol 1.5-2.5 mg/kg

DEVICE

Ultrasound

Ultrasound-guided suprascapular nerve block

DRUG

Sevoflurane

Sevoflurane 0.7-1.5 MAC in 40% oxygen

DRUG

Rocuronium

Rocuronium 0.6 mg/kg

Sponsors & Collaborators

• Mansoura University

  lead OTHER

Principal Investigators

• Hanaa M Elbendary, MD · Assistant Professor, MD anesthesia Department, Faculty of Medicine, Mansoura University, Egypt

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-07-31

Primary Completion

2018-12-31

Completion

2019-01-31

Countries

• Egypt

Study Locations