Interscalene Block Versus Serratus Posterior Superior Intercostal Plane Block for Arthroscopic Shoulder Surgery

NCT07311096 | Completed

• 1 other identifier: SBUERZURUMSHOULDER
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the effectiveness of interscalene (ISB) and serratus posterior superior intercostal plane block (SPSIP) for postoperative analgesia in patients undergoing elective arthroscopic shoulder surgery. The primary outcome is total 24-hour opioid consumption. Secondary outcomes include pain scores, hemidiaphragmatic paresis incidence and severity, duration of analgesia, and changes in lung function. Participants are randomized into ISB or SPSIP groups; blocks are performed under ultrasound guidance. Postoperative pain is managed with patient controlled analgesia(PCA).

Conditions

Shoulder Pain

Keywords

Postoperative pain; Analgesia; Regional Anesthesia; Interscalene brachial plexus block; Serratus posterior superior plane block

Outcome Measures

Primary Outcomes (1)

• Total 24-Hour Postoperative Opioid Consumption

  Total intravenous opioid consumption recorded for each patient during the first 24 hours after arthroscopic shoulder surgery, including any rescue analgesia administered.

  0-24 hours postoperatively

Secondary Outcomes (4)

• Incidence and Severity of Hemidiaphragmatic Paresis

  Pre-block and 30 minutes post-block

• Duration of Analgesia

  Time interval from block completion to initiation of IV PCA fentanyl in each patient

• Pulmonary Function Changes (FEV1)

  Pre-block and 30 minutes post-block

• Pulmonary Function Changes (FVC)

  Pre-block and 30 minutes post-block

Study Arms (2)

Interscalene Brachial Plexus Block (ISB)

EXPERIMENTAL

Patients will receive ISB under ultrasound guidance prior to arthroscopic shoulder surgery using 15 ml 0.25% bupivacaine.

Procedure: Interscalene Brachial Plexus Block (ISB)

Serratus Posterior Superior Intercostal Plane Block

EXPERIMENTAL

Patients will receive SPSIP block under ultrasound guidance using 30 ml 0.25% bupivacaine

Procedure: Serratus Posterior Superior Intercostal Plane Block (SPSIP)

Interventions

Interscalene Brachial Plexus Block (ISB) PROCEDURE

Patients receive ultrasound-guided ISB before arthroscopic shoulder surgery. 15 ml of 0.25% bupivacaine is injected using a 22 Gauge 50 mm needle with posterior in-plane approach, targeting C5-C6 roots.

Interscalene Brachial Plexus Block (ISB)

Serratus Posterior Superior Intercostal Plane Block (SPSIP) PROCEDURE

Patients receive ultrasound-guided SPSIP interfascial block in sitting position before surgery. Using a 22 Gauge 10 mm needle, 30 ml of 0.25% bupivacaine is injected between serratus posterior muscle and second rib.

Serratus Posterior Superior Intercostal Plane 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:

• Agreeing to participate in the study
• The American Society of Anesthesiologists I-III
• Scheduled for elective unilateral arthroscopic shoulder surgery

You may not qualify if:

• Refusal to participate in the study
• Allergy to the medications to be used
• History of serious heart, kidney or liver disease
• Neurological deficits or neuropathy
• History of anticoagulant use
• Pre-existing operative respiratory dysfunction
• Having chronic shoulder pain
• Being about to undergo open surgery

Sponsors & Collaborators

• Erzurum Regional Training & Research Hospital: lead

Study Sites (1)

Erzurum Regional Training Research Hospital

Erzurum, Yakutiye, 25100, Turkey (Türkiye)

Location

Related Publications (3)

• Kumari P, Kumar A, Aliyar R, Sinha L. Continuous serratus posterior superior intercostal plane block for postoperative analgesia in thoracotomy. Anaesth Crit Care Pain Med. 2025 Sep;44(5):101570. doi: 10.1016/j.accpm.2025.101570. Epub 2025 Jun 14. No abstract available.

  PMID: 40523524 BACKGROUND

• Dogan G, Kucuk O, Kayir S, Dal GC, Ciftci B, Zengin M, Alagoz A. Serratus posterior superior intercostal plane block versus thoracic paravertebral block for pain management after video-assisted thoracoscopic surgery: a randomized prospective study. Braz J Anesthesiol. 2025 Sep-Oct;75(5):844647. doi: 10.1016/j.bjane.2025.844647. Epub 2025 Jun 3.

  PMID: 40473018 BACKGROUND

• Ozen V, Turan EI, Alver S, Ciftci B, Cakir I, Sahin AS. Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia in a Pediatric Patient Undergoing Lobectomy: A Case Report. A A Pract. 2025 May 27;19(5):e01988. doi: 10.1213/XAA.0000000000001988. eCollection 2025 May 1.

  PMID: 40421887 BACKGROUND

MeSH Terms

Conditions

Shoulder Pain; Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Postoperative Complications; Pathologic Processes; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Officials

• Ömer Doymus, MD

  Erzurum Regional Training & Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: The anesthesiologist performing the blocks is aware of the group allocation; all other staff and outcome assessors are blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 16, 2025
• First Posted: December 30, 2025
• Study Start: December 1, 2024
• Primary Completion: December 1, 2025
• Study Completion: December 15, 2025
• Last Updated: December 30, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)