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Interscalene Block Versus Pericapsular Nerve Block and Superficial Cervical Plexus Block for Arthroscopic Shoulder Surgery

NCT05768009 · Status: UNKNOWN · Phase: NA · Type: INTERVENTIONAL · Enrollment: 42

Last updated 2023-03-16

No results posted yet for this study

Summary

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.

Conditions

  • Interscalene Block
  • Superficial Cervical Block

Interventions

PROCEDURE

Interscalene brachial plexus block (ISB)

• Group A will include 21 patients who will undergo the procedure under general anesthesia and ultrasound guided ISB using 10 ml bupivacaine 0.25%.

Sponsors & Collaborators

  • Tanta University

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
65 Years
Sex
ALL
Healthy Volunteers
Yes

Timeline & Regulatory

Start
2023-03-25
Primary Completion
2023-09-25
Completion
2023-09-25

Countries

  • Egypt

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05768009 on ClinicalTrials.gov