Comparative Analgesia and Respiratory Effects of Shoulder Blocks

NCT07429669 | Recruiting

• 1 other identifier: AEŞH-EK-2026-020
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Interscalene block is widely accepted as the gold-standard regional analgesic technique for pain control after arthroscopic shoulder surgery. However, because this block is performed at the level of the brachial plexus roots, it may be associated with adverse effects such as phrenic nerve blockade and subsequent diaphragmatic dysfunction. These limitations have prompted the search for alternative regional anesthesia techniques that can provide effective postoperative analgesia while preserving respiratory function. The anterior suprascapular block, which covers a broad dermatomal distribution of the shoulder region, has been shown in some studies to provide sufficient analgesia as a standalone technique. In addition, the pericapsular nerve group (PENG) block of the shoulder-applied around the anterior capsule and performed at a distance from critical neurovascular structures that may lead to serious complications-may represent another potential analgesic option following arthroscopic shoulder procedures. Therefore, this study aims to evaluate alternative regional block techniques in comparison with the interscalene block and to contribute to the identification of an optimal analgesic strategy after arthroscopic shoulder surgery.

Conditions

Arthroscopic Shoulder Surgery; Postoperative Pain

Keywords

Interscalene block; Anterior suprascapular block; Pericapsular nerve group block; Shoulder Block; Arthroscopic shoulder surgery; Pain, acute; Pain, Postoperative

Outcome Measures

Primary Outcomes (1)

• Pain scores

  Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain) at the first postoperative hour.

  First hour after the surgery

Secondary Outcomes (4)

• Pain scores

  First 24 hours after surgery

• Forced vital capacity (FVC) (volume)

  Perioperative period

• Forced expiratory flow in 1 s (FEV1) (volume)

  Perioperative period

• FEV1/FVC

  Perioperative period

Study Arms (3)

Interscalene block

ACTIVE COMPARATOR

In the preoperative period, 10 mL of 0.25% bupivacaine will be injected between C5 and C6 using an in-plane technique guided by a linear ultrasound (US) probe.

Procedure: Interscalene block

Anterior suprascapular block

ACTIVE COMPARATOR

A linear ultrasound probe will be positioned in the supraclavicular fossa, parallel to the clavicle. The suprascapular nerve will be identified as a hyperechoic oval structure deep to the omohyoid muscle and posterior-lateral to the brachial plexus. 10 mL of local anesthetic will be injected under the omohyoid muscle, around the suprascapular nerve.

Procedure: Anterior suprascapular block

Pericapsular nerve group (PENG) block

ACTIVE COMPARATOR

A linear ultrasound probe will be placed sagittally, near the axillary region, just below the coracoid process. The subscapularis muscle and its tendon will be visualized. The target area is the space between the deep fascia of the subscapularis muscle and the anterior surface of the shoulder joint capsule. The needle will pass the subscapularis muscle and be guided into the plane between the capsule and the muscle, where 20 mL of local anesthetic will be dispensed to block the articular branches innervating the capsule.

Procedure: Pericapsular nerve group (PENG) block

Interventions

Interscalene block PROCEDURE

Interscalene block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.

Interscalene block

Anterior suprascapular block PROCEDURE

Anterior suprascapular block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.

Anterior suprascapular block

Pericapsular nerve group (PENG) block PROCEDURE

Pericapsular nerve group (PENG) block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.

Pericapsular nerve group (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:

• Patients with ASA scores I-II-III
• Patients scheduled for elective arthroscopic shoulder surgery
• Patients who have been informed about the study and have given written consent will be included.

You may not qualify if:

• Those with a known allergy to local anesthetics
• Those with an infection at the application site
• Those with a severe coagulopathy disorder or anticoagulant use
• Those with contralateral phrenic nerve palsy or a serious pulmonary diagnosis
• Those with a history of chronic opioid use or neuropathic pain

Sponsors & Collaborators

• Atatürk Chest Diseases and Chest Surgery Training and Research Hospital: lead

Study Sites (1)

Ankara Etlik City Hospital

Yenimahalle, Ankara, 06170, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative; Acute Pain

Interventions

Dental Occlusion

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; 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: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal İnvestigator

Study Record Dates

• First Submitted: February 13, 2026
• First Posted: February 24, 2026
• Study Start: February 23, 2026
• Primary Completion (Estimated): November 10, 2026
• Study Completion (Estimated): November 30, 2026
• Last Updated: February 24, 2026

Record last verified: 2026-02

Locations

TU (1)