Serratus Anterior Plane Block Versus Pericapsular Nerve Group Block for Shoulder Surgery

NCT05772533 | Completed

• 1 other identifier: SAPB for shoulder surgery
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Effective analgesia in arthroscopic shoulder surgery is a major concern and is essential for all aspects of the patient's recovery. The aim of this study is to assess the quality of pain relief in patients who will undergo arthroscopic shoulder surgeries receiving either serratus anterior plane block versus PENG block comparing and evaluating the differences between the two techniques.It is hypothesized that PENG block will be comparable to serratus anterior plane block as a promising effective alternative for analgesia for arthroscopic shoulder surgeries with fewer side effects. It is suggested that the PENG block can be safely applied for analgesia.

Conditions

Shoulder Surgery

Keywords

Pericapsular nerve group block

Outcome Measures

Primary Outcomes (1)

• Visual analogue score (VAS) for pain assessment at 6 hour postoperative

  VAS score from 0 to 10 (0 = no pain and 10 = the worst imaginable pain) will be assessed 6 hour after the procedure.

  at 6 hour after the procedure

Secondary Outcomes (6)

• First analgesic request

  Up to 24 hours after the procedure

• Total analgesic requirements of fentanyl

  Up to 24 hours after the procedure

• Visual analogue score (VAS) for pain assessment

  Up to 24 hours after the procedure

• Heart rate (HR)

  During the procedure

• Mean arterial blood pressure (MAP)

  During the procedure

Study Arms (2)

Group A (SAPB)

ACTIVE COMPARATOR

Ultrasound-guided SAPB will be applied while the patient is in the supine position.

Procedure: Serratus anterior plane block

Group B (PENG block)

ACTIVE COMPARATOR

Ultrasound-guided PENG block will be performed under strict aseptic precautions and patient's arm will be placed in external rotation and abducted at 45 degrees

Procedure: PENG block

Interventions

Serratus anterior plane block PROCEDURE

The latissimus dorsi muscle between the midaxillary line and the posterior axillary line will be located under ultrasound guidance. The needle will be inserted into the plane from top to bottom until the serratus anterior surface, and the injectate will be slowly administered.

Group A (SAPB)

PENG block PROCEDURE

Ultrasound-guided PENG block will be performed under strict aseptic precautions and patient's arm will be placed in external rotation and abducted at 45 degrees. A linear ultrasound probe will be placed longitudinally between the coracoid and the humeral head. After defining the humeral head, the tendon of the subscapular muscle and the deltoid muscle over it, the needle will be inserted using the "in plane" technique. When the needle will have passed through the deltoid muscle and touched the subscapularis tendon, a bone-like hard tissue will be felt and the needle could not be advanced further. The needle tip will be placed Between the deltoid muscle and subscapularis tendon, and the injectate will be slowly administered.

Group B (PENG block)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• American Society of Anesthesiology (ASA) 1 or 2 patients.
• Scheduled for elective unilateral shoulder arthroscopy.

You may not qualify if:

• Patient's refusal.
• Altered mental status or un-cooperative patients.
• History of known sensitivity to the used anesthetics.
• Bleeding or coagulation diathesis.
• Infection or redness at the injection site.
• Significant cardiac dysfunction, hepatic, or renal impairment.

Sponsors & Collaborators

• Mansoura University: lead

Study Sites (1)

Mansoura University

Al Mansurah, 35511, Egypt

Location

Related Publications (7)

• Casas Reza P, Dieguez Garcia P, Gestal Vazquez M, Sampayo Rodriguez L, Lopez Alvarez S. Pericapsular nerve group block for hip surgery. Minerva Anestesiol. 2020 Apr;86(4):463-465. doi: 10.23736/S0375-9393.20.14166-X. Epub 2020 Jan 28. No abstract available.

  PMID: 32000476 BACKGROUND

• van Erp JHJ, Ostendorf M, Lansdaal JR. Shoulder surgery in beach chair position causing perioperative stroke: Four cases and a review of the literature. J Orthop. 2019 May 27;16(6):493-495. doi: 10.1016/j.jor.2019.05.009. eCollection 2019 Nov-Dec.

  PMID: 31680738 BACKGROUND

• Kapukaya F, Ekinci M, Ciftci B, Atalay YO, Golboyu BE, Kuyucu E, Demiraran Y. Erector spinae plane block vs interscalene brachial plexus block for postoperative analgesia management in patients who underwent shoulder arthroscopy. BMC Anesthesiol. 2022 May 12;22(1):142. doi: 10.1186/s12871-022-01687-5.

  PMID: 35550031 BACKGROUND

• Kupeli I, Yazici Kara M. Anesthesia or analgesia? New block for shoulder surgery: pericapsular nerve group block. Braz J Anesthesiol. 2022 Sep-Oct;72(5):669-672. doi: 10.1016/j.bjane.2021.05.009. Epub 2021 Jun 9.

  PMID: 34118263 BACKGROUND

• Patel MS, Abboud JA, Sethi PM. Perioperative pain management for shoulder surgery: evolving techniques. J Shoulder Elbow Surg. 2020 Nov;29(11):e416-e433. doi: 10.1016/j.jse.2020.04.049. Epub 2020 Jun 9.

  PMID: 32844751 BACKGROUND

• Sripada R, Bowens C Jr. Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to present. Int Anesthesiol Clin. 2012 Winter;50(1):26-46. doi: 10.1097/AIA.0b013e31821a0284.

  PMID: 22227421 BACKGROUND

• Zhu H, Zhang C, Yan C. The Anesthetic Effect of Ultrasound-Guided Serratus Anterior Plane Block in Arthroscopic Shoulder Surgery and Its Effect on Postoperative Analgesia. J Healthc Eng. 2022 Mar 15;2022:8968805. doi: 10.1155/2022/8968805. eCollection 2022.

  PMID: 35356610 BACKGROUND

Study Officials

• EL-Deeb

  Faculty of Medicine, Mansoura University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: The study subjects and the resident assessing the outcomes will be blinded to the study group. A single investigator will assess the patients for eligibility, obtain written informed consent, open the sealed opaque envelopes containing group allocation, perform the block, and administer bupivacaine solution.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of anesthesia, ICU & pain management; Faculty of Medicine

Model Details: Prospective, randomized, double blind study

Study Record Dates

• First Submitted: March 6, 2023
• First Posted: March 16, 2023
• Study Start: May 21, 2023
• Primary Completion: February 15, 2024
• Study Completion: March 10, 2024
• Last Updated: May 30, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)