Comparison of SPSIPB With SSB and ICB Combination in Arthroscopic Shoulder Surgeries

NCT07233681 | Completed

• 1 other identifier: 2024-01/07
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The aim to compare postoperative analgesic requirements between patients undergoing arthroscopic shoulder surgery who received either the SSB-ICB combination or SPSIPB, and to determine whether one technique has superiority over the other.

Conditions

Pain After Shoulder Surgery; Shoulder Arthroscopic Surgery

Keywords

suprascapular nerve block; infraclavicular nerve block; Serratus posterior superior intercostal plane block; postoperative pain; arthroscopic shoulder surgery

Outcome Measures

Primary Outcomes (2)

• Numeric Rating Scale (NRS)

  Numeric Rating Scale (NRS): The patient selects a number between 0, representing "no pain," and 10 or 100, representing "unbearable pain." This method is highly sensitive and is one of the most commonly used pain scoring tools.

  24 hours after surgery

• Total tramadol consumption

  Total postoperative analgesic (tramadol) requirement was recorded in the unit as "milligrams".

  24 hours after surgery

Secondary Outcomes (2)

• Diaphragm Excursion Difference

  Preoperatively, immediately before anesthesia induction, and postoperatively, 30 minutes after emergence from anesthesia (when a modified Aldrete score of 9 is reached)

• Quality of Recovery-15 Patient Questionnaire (QoR-15)

  24th hour after surgery

Study Arms (2)

Combination of SSB and ICB

ACTIVE COMPARATOR

Immediately after anesthesia induction, anterior suprascapular nerve block (SSB) and infraclavicular brachial plexus block (ICB) will be performed on the ipsilateral side with the patient supine. For ICB, a high-frequency linear ultrasound probe is placed sagittally over the lateral infraclavicular fossa, medial to the coracoid process and caudal to the clavicle. The needle is inserted below the clavicle, directed cephalad-to-caudal through the pectoralis major and minor toward the posterior aspect of the axillary artery, and 15 mL of 0.25% bupivacaine is injected. For SSB, the probe is positioned over the supraclavicular fossa in a sagittal oblique plane to visualize the subclavian artery and brachial plexus. The suprascapular nerve is identified beneath the omohyoid muscle, the needle is advanced in-plane from lateral to medial, and 10 mL of 0.25% bupivacaine is administered.

Procedure: suprascapular nerve block

SPSIPB

ACTIVE COMPARATOR

The ultrasound probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the ribs. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the shoulder undergoing surgery.

Procedure: Serratus posterior superior intercostal plane block

Interventions

suprascapular nerve block PROCEDURE

Suprascapular nerve block (SSB): 10ml of 0.25% bupivacaine was injected around the suprascapular nerve beneath the omohyoid muscle. Infraclavikular nerve block(ICB): The needle is inserted below the clavicle, directed cephalad-to-caudal through the pectoralis major and minor toward the posterior aspect of the axillary artery, and 15 mL of 0.25% bupivacaine is injected

Combination of SSB and ICB

Serratus posterior superior intercostal plane block PROCEDURE

Serratus posterior superior intercostal plane block (SPSIPB): 30 ml of 0.25% bupivacaine was injected into the plane between the serratus posterior superior muscle and the ribs.

SPSIPB

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients older than 18 years of age who underwent arthroscopic shoulder surgery under general anesthesia and were American Society of Anesthesiologists (ASA) I-II-III according to the ASA risk classification.

You may not qualify if:

• patients who did not give consent,
• patients with coagulopathy,
• patients with signs of infection at the block application site,
• patients using anticoagulants,
• patients with local anesthetic drug allergies,
• patients with unstable hemodynamics,
• patients who could not cooperate during postoperative pain assessment
• patients diagnosed with frozen shoulder

Sponsors & Collaborators

• Cumhuriyet University: lead

Study Sites (1)

Sivas Cumhuriyet University

Sivas, Sivas, 58140, Turkey (Türkiye)

Location

Related Publications (2)

• Auyong DB, Hanson NA, Joseph RS, Schmidt BE, Slee AE, Yuan SC. Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery: A Randomized, Double-blind, Noninferiority Trial. Anesthesiology. 2018 Jul;129(1):47-57. doi: 10.1097/ALN.0000000000002208.

  PMID: 29634491 RESULT

• Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Korkmaz AO, Bozkurt NN, De Cassai A, Torres AJ, Elsharkawy H, Alici HA. Serratus Posterior Superior Intercostal Plane Block: A Technical Report on the Description of a Novel Periparavertebral Block for Thoracic Pain. Cureus. 2023 Feb 3;15(2):e34582. doi: 10.7759/cureus.34582. eCollection 2023 Feb.

  PMID: 36883093 RESULT

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: November 18, 2025
• Study Start: February 15, 2024
• Primary Completion: November 20, 2024
• Study Completion: December 20, 2024
• Last Updated: November 18, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)