The Analgesic Effect of (SHAC) Block Versus Suprascapular Nerve Block in Arthroscopic Shoulder Surgeries

NCT06529393 | Not Yet Recruiting

• 1 other identifier: SHAC Block
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to compare the post-operative analgesic effect of Shoulder anterior capsule (SHAC) block with Suprascapular nerve block for arthroscopic shoulder surgery with a hypothesis that both Shoulder anterior capsule (SHAC) block and Suprascapular nerve block are effective in providing postoperative analgesia for arthroscopic shoulder surgery.

Conditions

Shoulder Pain; Postoperative Pain

Keywords

SHAC Block

Outcome Measures

Primary Outcomes (1)

• effect on postopeartive pain after shoulder arthrscopy

  the pain intensity assessment at rest and on coughing using Numerical Rating Scale (NRS) This will measure pain intensity from 0 to 10 , 0: no pain 3:mild pain 7:moderate pain 10:severe pain

  baseline

Secondary Outcomes (3)

• -inceidence of (POVN) 24 hours postoperatively -Block related complications during and after block procedure till 24 hours postoperatively (LAST, pneumohorax and vascular puncture during block procedure)

  first 24 hours

• -Time of the first opioid request

  first 24 hour

• -Block related complications during and after block procedure till 24 hours postoperatively (LAST, pneumohorax and vascular puncture during block procedure)

  first 24 hours

Study Arms (2)

SHAC block group

ACTIVE COMPARATOR

For the SHAC block, with the patient in a beach-chair position and with the arm in extension, the subscapularis muscle is stretched posteriorly and becomes easily visible. With external rotation and abduction, the coracobrachialis and the biceps brachii muscles are displaced, allowing the visualization of the interfascial space between the deep lamina of the deltoid muscle fascia and the superficial lamina of the subscapularis fascia.Once the injection into the fascial space is achieved, the investigators can proceed towards the glenohumeral pericapsular space by crossing the subscapularis muscle with the needle. By injecting the pericapsular space, the investigators reach the terminal articular branches indistinctly from their origin. Furthermore, through the Weitbrecht foramen, a natural capsular foramen between the upper and middle glenohumeral ligaments, we also reach the intra-articular space .

Procedure: SHAC block

Suprascapular nerve block group

ACTIVE COMPARATOR

Patients will be placed in lateral position by using A high - frequency linear ultrasound probe will be placed approximately 2 cm medial to the medial border of the acromion and about 2 cm cranial to the superior margin of the scapular spine until supraspinatus or infraspinatus muscle contractions were elicited. Following negative aspiration,A 21G 10-cm needle will be inserted using an in-plane approach .The tip of the needle will be placed at the floor of the supraspinatus fossa where the nerve has passed .A volume of 15 mL of a mixture of 2% lidocaine (5 mL) and 0.5% levobupivacaine (10 mL) was injected.

Procedure: suprascapular nerve block

Interventions

SHAC block PROCEDURE

with the patient in a beach-chair position and with the arm in extension, the subscapularis muscle is stretched posteriorly and becomes easily visible. With external rotation and abduction, the coracobrachialis and the biceps brachii muscles are displaced, allowing the visualization of the interfascial space between the deep lamina of the deltoid muscle fascia and the superficial lamina of the subscapularis fascia.Once the injection into the fascial space is achieved, the investigators can proceed towards the glenohumeral pericapsular space by crossing the subscapularis muscle with the needle. By injecting the pericapsular space, the investigators reach the terminal articular branches indistinctly from their origin. Furthermore, through the Weitbrecht foramen, a natural capsular foramen between the upper and middle glenohumeral ligaments, the investigators also reach the intra-articular space .

Also known as: shoulder anterior capsule block

SHAC block group

suprascapular nerve block PROCEDURE

Patients will be placed in lateral position by using A high - frequency linear ultrasound probe will be placed approximately 2 cm medial to the medial border of the acromion and about 2 cm cranial to the superior margin of the scapular spine until supraspinatus or infraspinatus muscle contractions were elicited. Following negative aspiration,A 21G 10-cm needle will be inserted using an in-plane approach .The tip of the needle will be placed at the floor of the supraspinatus fossa where the nerve has passed .A volume of 15 mL of a mixture of 2% lidocaine (5 mL) and 0.5% levobupivacaine (10 mL) was injected.

Suprascapular nerve block group

Eligibility Criteria

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

You may qualify if:

• Age between 18-65 years.
• Body mass index (BMI)of 18-35Kg /m2.
• Patients with American society of anesthesiologist (ASA) physical status \| / \|\|.
• Patients scheduled for elective Arthroscopic Shoulder Surgery.
• Both sexes, males and females.

You may not qualify if:

• Patient refusal.
• Allergy to local anaesthetics.
• Infection at the site of injection .
• Coagulopathy.
• Chronin pain syndromes.
• Prolonged opioid medication
• Patients who received any analgesia 24 h before surgery.
• pregnancy

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

New Trauma Hospital

Asyut, Egypt

Location

Related Publications (5)

• Fredrickson MJ, Krishnan S, Chen CY. Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. Anaesthesia. 2010 Jun;65(6):608-624. doi: 10.1111/j.1365-2044.2009.06231.x.

  PMID: 20565394 BACKGROUND

• Paxton ES, Backus J, Keener J, Brophy RH. Shoulder arthroscopy: basic principles of positioning, anesthesia, and portal anatomy. J Am Acad Orthop Surg. 2013 Jun;21(6):332-42. doi: 10.5435/JAAOS-21-06-332.

  PMID: 23728958 BACKGROUND

• Singelyn FJ, Lhotel L, Fabre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg. 2004 Aug;99(2):589-92, table of contents. doi: 10.1213/01.ANE.0000125112.83117.49.

  PMID: 15271745 BACKGROUND

• Basat HC, Ucar DH, Armangil M, Guclu B, Demirtas M. Post operative pain management in shoulder surgery: Suprascapular and axillary nerve block by arthroscope assisted catheter placement. Indian J Orthop. 2016 Nov-Dec;50(6):584-589. doi: 10.4103/0019-5413.193474.

  PMID: 27904211 BACKGROUND

• Brenner W, Bohuslavizki KH, Wolf H, Sippel C, Clausen M, Henze E. Radiotherapy with iodine-131 in recurrent malignant struma ovarii. Eur J Nucl Med. 1996 Jan;23(1):91-4. doi: 10.1007/BF01736995.

  PMID: 8586108 BACKGROUND

MeSH Terms

Conditions

Shoulder Pain; Pain, Postoperative

Interventions

Dental Occlusion

Condition Hierarchy (Ancestors)

Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Postoperative Complications; Pathologic Processes

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena

Study Officials

• Mohamed S Hassanen, professor

  Assuit university Hospital

  STUDY CHAIR

• Rana EA Ibrahim, Resident

  Assuit university Hospital

  PRINCIPAL INVESTIGATOR

• Ayman Abdel Khalek, Ass professor

  Assuit university Hospital

  STUDY DIRECTOR

Central Study Contacts

Rana EA Ibrahim, Resident

CONTACT

00201069626195; relsayed324@gmail.com

Ayman M Abdel Khalek, Ass professor

CONTACT

00201025675901; Aymanglala@aun.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: doctor

Model Details: For the SHAC block, with the patient in a beach-chair position and with the arm in extension,With external rotation and abduction,A 21G 10-cm needle will be inserted using an in-plane approach .The tip of the needle will be placed at the space where the nerve has passed .A volume of 15 mL of a mixture of 2% lidocaine (5 mL) and 0.5% levobupivacaine (10 mL) was injected By injecting the pericapsular space, we reach the terminal articular branches indistinctly from their origin. For suprascapular nerve block : Patients will be placed in lateral position until supraspinatus or infraspinatus muscle contractions were elicited. Following negative aspiration,A 21G 10-cm needle will be inserted using an in-plane approach .The tip of the needle will be placed at the floor of the supraspinatus fossa where the nerve has passed .A volume of 15 mL of a mixture of 2% lidocaine (5 mL) and 0.5% levobupivacaine (10 mL) was injected.

Study Record Dates

• First Submitted: July 15, 2024
• First Posted: July 31, 2024
• Study Start: March 1, 2025
• Primary Completion: December 1, 2025
• Study Completion: February 1, 2026
• Last Updated: February 24, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)