A Comparison of ESP Block to SSN Block for Analgesia in Shoulder Surgery

NCT04669639 | Completed

• 1 other identifier: #6506
• Study Type: interventional
• Target: 96
• Locations: 1 country
• Sites: 1

Brief Summary

A comparison between Erector Spinae Plane block and Suprascapular nerve block in providing analgesia for shoulder surgery

Conditions

Arthroscopic Shoulder Surgery

Keywords

erector spinae plane block- suprascapular nerve

Outcome Measures

Primary Outcomes (1)

• Intraoperative analgesia

  Recording of the patients' hemodynamics (heart rate and non-invasive blood pressure) and total dose of opioids consumption intraoperatively and postoperatively.

  The intraoperative patients' hemodynamics every 30 min were collected and analyzed till the end of surgery . Also the total dose of opioids consumed intraoperatively will be recorded. Postoperative consumed opioid for 24 hours also will calculated

Study Arms (3)

The block group (a)

EXPERIMENTAL

Patients were randomized in a 1:1 :1ratio, group (a) will receive SSN. The nerve blocks The procedure will be performed after induction of anaesthesia and endotracheal intubation.

Other: Block procedures for shoulder surgery analgesia

The block group (b)

EXPERIMENTAL

Patients were randomized in a 1:1:1 ratio. group (b) will receive the Erector spinae plane block. The procedure will be performed after induction of anesthesia and endotracheal intubation.

Other: Block procedures for shoulder surgery analgesia

control group

PLACEBO COMPARATOR

Patients were randomized in a 1:1:1 ratio. this group will receive general anesthesia (GA) only

Other: Block procedures for shoulder surgery analgesia

Interventions

Block procedures for shoulder surgery analgesia OTHER

The patients in group (a) will be placed in lateral decubitus. Then, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used to locate the transverse process of T2, where a needle will be inserted in a cephalocaudal direction until reaching the space between the fascia of the erector spinae and the transverse process of T2 and 30 ml of local anesthetic of bupivacaine 0.5% will be injected. * In group (b), SSC nerve block will be done as follow: In the suprascapular notch, an ultrasound-guided aseptic technique with a high-frequency linear transducer will be used. The linear probe, enveloped in a sterile sheath, will be placed parallel to the spine of the scapula to visualize it and then will be moved cephalic to the supraspinatus fossa. The probe will then be moved laterally up to the scapular notch, where the nerve will be identified by its round hyperechogenic shape 4 cm deep. * control group: patients will receive only general anesthesia

The block group (a); The block group (b); control group

Eligibility Criteria

• Age: 21 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• ASA I and II,
• Age above 21 years and below 60 years in both sexes,
• Cooperative patients,
• Patients with a BMI (body mass index) not exceeding 35.

You may not qualify if:

• patients with cardiovascular or respiratory compromise,
• Patient refusal,
• Coagulopathy,
• Local tissue infection,
• Allergy to local anesthesia,
• prior to cervical or thoracic spine surgery.

Sponsors & Collaborators

• Zagazig University: lead

Study Sites (1)

Faculty of Medicine, Zagazig University

Zagazig, 44519, Egypt

Location

Related Publications (4)

• Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg. 1991 Apr;72(4):498-503. doi: 10.1213/00000539-199104000-00014.

  PMID: 2006740 BACKGROUND

• Ma W, Sun L, Ngai L, Costouros JG, Steffner R, Boublik J, Tsui BCH. Motor-sparing high-thoracic erector spinae plane block for proximal humerus surgery and total shoulder arthroplasty surgery: clinical evidence for differential peripheral nerve block? Can J Anaesth. 2019 Oct;66(10):1274-1275. doi: 10.1007/s12630-019-01442-4. Epub 2019 Jul 9. No abstract available.

  PMID: 31290120 BACKGROUND

• Hussain N, Goldar G, Ragina N, Banfield L, Laffey JG, Abdallah FW. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017 Dec;127(6):998-1013. doi: 10.1097/ALN.0000000000001894.

  PMID: 28968280 BACKGROUND

• Abdelhaleem NF, Abdelatiff SE, Abdel Naby SM. Comparison of Erector Spinae Plane Block at the Level of the Second Thoracic Vertebra With Suprascapular Nerve Block for Postoperative Analgesia in Arthroscopic Shoulder Surgery. Pain Physician. 2022 Nov;25(8):577-585.

  PMID: 36375187 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, OUTCOMES ASSESSOR
• Masking Details: The care provider and outcome assessor will be unaware of the study design
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer, Anesthesia and Surgical Intensive Care department, Faculty of Medicine

Model Details: There has been a recent renewed interest in using the suprascapular nerve block (SSNB) as a phrenic nerve sparing approach for analgesia after shoulder surgery. The suprascapular nerve provides 70% of the sensory input to the glenohumeral joint and also innervates the infraspinatus and supraspinatus muscles. However, some researchers suggest that SSNB alone cannot provide a sufficient analgesia.The high-thoracic erector spinae plane block (HT-ESPB) has been described in several case reports as an effective analgesic modality for the shoulder region without causing motor or phrenic nerve block

Study Record Dates

• First Submitted: November 25, 2020
• First Posted: December 17, 2020
• Study Start: December 20, 2020
• Primary Completion: September 10, 2021
• Study Completion: November 10, 2021
• Last Updated: May 24, 2022

Record last verified: 2020-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR
• Time Frame: once the paper is published and become available online
• Access Criteria: for all anaesthesiologists

Locations

EG (1)