Comparison of Interscalene and Anterior Shoulder Capsule Block

NCT06827912 | Completed

• 1 other identifier: 2024-106
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

Due to the development and easy availability of ultrasonography devices, regional nerve blocks are routinely used by anesthesiologists among multimodal analgesia techniques. Interscalene and supraclavicular nerve blocks are the leading regional anesthesia techniques for shoulder surgeries. However, due to the phrenic nerve involvement and loss of motor function in the upper extremity in these block techniques, new nerve blocks have been developed and used for postoperative analgesia. One of the blocks that has been used increasingly in shoulder region surgeries and does not cause phrenic nerve involvement is the shoulder anterior capsule block (SHAC). The aim of this study is to compare the postoperative analgesic effects of interscalene nerve block and SHAC block in patients undergoing arthroscopic rotator cuff repair surgery.

Conditions

Pain Intensity Assessment; Interscalene Nerve Block; Shoulder Anterior Capsule Block (SHAC Block); Pericapsular Nerve Group Block (PENG)

Keywords

Pain Management; Interscalene Block; Shoulder Anterior Capsular Block; Pericapsuler nerve group block; SHAC; PENG; Rotator cuff repair

Outcome Measures

Primary Outcomes (1)

• Postoperative 12th hour pain score

  Postoperative 12th hour pain score (will be evaluated with Numeric Rating Scale) Higher scores indicate worse condition

  Postoperative 12th hour

Secondary Outcomes (6)

• Postoperative 1, 2, 4, 8, 12, 16, 24, 48 hours pain score

  Postoperative 1, 2, 4, 8, 12, 16, 24, 48 hours

• Amount of opioid consumption

  in the first 24 hours postoperatively

• Complications related to opioid use

  in the first 24 hours postoperatively

• Elephant flexion motor strength evaluation

  in the first 24 hours postoperatively

• Surgeon satisfaction level with Likert scale

  during surgery

Study Arms (2)

Interscalene Block Group

ACTIVE COMPARATOR

Procedure: Shoulder Anterior Capsule Block

SHAC Block Group

ACTIVE COMPARATOR

Procedure: Interscalene Nerve Block

Interventions

Interscalene Nerve Block PROCEDURE

After sterile conditions are provided with the patient in the supine position, the brachial plexus will be identified in the supraclavicular fossa above the clavicle with ultrasonography. The transducer will be directed cephalad and 20 cc 0.5% bupivacaine will be applied to the interscalene space with a 50 mm block needle from the point where the C 5-6-7 nerve roots give the impression of a rosary bead between the anterior and medial scalene muscles.

SHAC Block Group

Shoulder Anterior Capsule Block PROCEDURE

In pericapsular nerve block application, the patient will be placed in a supine position and the arm will be externally rotated and abducted to 45 degrees. After sterile conditions are provided, the humerus head, the tendon of the subscapularis muscle and the deltoid muscle above it will be identified with ultrasonography. 15 cc of 0.5% bupivacaine will be injected into the interfascial space between the deltoid muscle and the subscapularis muscle with a 22gauge 50 mm block needle. Then, the block needle will be directed deep into the subscapularis muscle and another 5 cc of 0.5% bupivacaine will be injected under the subscapularis muscle.

Interscalene Block Group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ASA 1-2 patients who will undergo arthroscopic rotator cuff repair,
• Patients between the ages of 18-75

You may not qualify if:

• Allergy to local anesthetics
• Infection at the block site
• Neuropathy in the involved extremity
• History of chronic opioid use
• Revision surgery
• History of hepatic and renal failure
• History of peripheral neuropathy
• History of diabetes mellitus

Sponsors & Collaborators

• Amasya University: lead

Study Sites (1)

Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital

Amasya, Amasya, 05200, Turkey (Türkiye)

Location

Related Publications (4)

• Yamak Altinpulluk E, Teles AS, Galluccio F, Simon DG, Olea MS, Salazar C, Fajardo Perez M. Pericapsular nerve group block for postoperative shoulder pain: A cadaveric radiological evaluation. J Clin Anesth. 2020 Dec;67:110058. doi: 10.1016/j.jclinane.2020.110058. Epub 2020 Sep 26. No abstract available.

  PMID: 32987232 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

• Galluccio F, Fajardo Perez M, Yamak Altinpulluk E, Hou JD, Lin JA. Evaluation of Interfascial Plane and Pericapsular Nerve Blocks to the Shoulder Joint: A Preliminary Analysis of Shoulder Anterior Capsular Block. Pain Ther. 2021 Dec;10(2):1741-1754. doi: 10.1007/s40122-021-00326-0. Epub 2021 Oct 20.

  PMID: 34669181 BACKGROUND

• Cam BM, Tuzen AS, Duran HT, Akdogan MA. Comparison of interscalene block versus shoulder anterior capsule block for postoperative pain management in rotator cuff surgery: a randomized controlled trial. BMC Anesthesiol. 2025 Sep 29;25(1):459. doi: 10.1186/s12871-025-03351-0.

  PMID: 41023793 DERIVED

MeSH Terms

Conditions

Agnosia

Interventions

Dental Occlusion

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Specialist Doctor

Study Record Dates

• First Submitted: February 10, 2025
• First Posted: February 14, 2025
• Study Start: February 20, 2025
• Primary Completion: April 2, 2025
• Study Completion: April 2, 2025
• Last Updated: April 9, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)