Erector Spinae Plane Block Versus Infraspinatus-Teres Minor Interfascial Plane Block for Analgesia After Shoulder Arthroscopy

NCT07688395 | Not Yet Recruiting

• 1 other identifier: 2024-KAEK-12
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The shoulder, being an anatomical region innervated by different nerves, has a wide variety of analgesic approaches, which differ depending on the practitioner. New approaches are being developed based on the different innervation channels demonstrated in clinical and cadaver studies. Over time, the effectiveness of axillary block, suprascapular block, interscalene block, local infiltration, and various combinations, as well as non-regional methods, has been observed. The goal of these approaches is to achieve the highest possible level of patient comfort, high analgesic efficacy, and minimal complications. Studies have shown that the interscalene block has the highest analgesic efficacy and the most ideal postoperative results; therefore, it is frequently used as the gold standard in this field. Providing effective analgesia with a single intervention can also be cited as an aspect that increases patient comfort and simplifies the procedure. In interscalene block; unilateral transient diaphragmatic paralysis due to the spread of local anesthetics to the C7 nerve root, respiratory problems and potential spinal/epidural complications, new approaches are being followed and researched. Results from cervical/high thoracic erector spinae plane block (ESPB) and infraspinatus-teres minor interfascial plane block (ITMIPB) studies, which are the subject of new studies, strengthen the hypothesis that they provide effective analgesia. Neither of these blocks, performed with ultrasonography, carries the risks present in interscalene block. Although the usual risks of a peripheral nerve block are present for these procedures; the block sites are considered safer due to its distance from vascular structures and the reduced risk of additional complications. While small sample studies exist for each type of block, no studies comparing their effectiveness have been found. Besides reduced complications, another advantage of these two blocks is their ability to provide effective analgesia with a single-point injection. The aim of this study is to compare the analgesic efficacy of Cervical Erector Spine Plane Block (ESP) and Infraspinatus-Teres Minor Interfascial Plane Block (ITMIPB) applied for postoperative analgesia in ASA I-III patients undergoing shoulder surgery.

Conditions

Shoulder Arthroscopic Surgery

Keywords

postoperative analgesia; regional anesthesia; shoulder arthroscopy; ultrasonography

Outcome Measures

Primary Outcomes (1)

• Postoperative pain intensity

  Pain intensity assessed using the 11-point Numeric Rating Scale (NRS; 0=no pain, 10=worst imaginable pain).

  Postoperative 1., 6., 12. and 24. hour

Secondary Outcomes (3)

• Total postoperative analgesic consumption

  24 hours after surgery

• Incidence of postoperative nausea and vomiting (PONV)

  24 hours after surgery

• Block-related complications

  24 hours after surgery

Study Arms (2)

Erector Spinae Plane Block Group

ACTIVE COMPARATOR

Patients receiving ultrasound-guided cervical erector spinae plane block for postoperative analgesia.

Procedure: cervical erector spinae plane block; Drug: Bupivacaine %0.25 (isobaric)

Infraspinatus Teres Minor Interfascial Plane Block Group

ACTIVE COMPARATOR

Patients receiving ultrasound-guided Infraspinatus Teres Minor Interfascial Plane Block for postoperative analgesia.

Procedure: Infraspinatus Teres Minor Interfascial Plane Block; Drug: Bupivacaine %0.25 (isobaric)

Interventions

cervical erector spinae plane block PROCEDURE

Before shoulder surgery, Ultrasound-guided C8-T1 ESP block will be performed for postoperative analgesia

Erector Spinae Plane Block Group

Infraspinatus Teres Minor Interfascial Plane Block PROCEDURE

Before surgery, Ultrasound-guided Infraspinatus Teres Minor Interfascial Plane Block will be performed for postoperative analgesia

Infraspinatus Teres Minor Interfascial Plane Block Group

Bupivacaine %0.25 (isobaric) DRUG

In the both groups, peripheral nerve blocks are performed by using Bupivacaine %0,25.

Erector Spinae Plane Block Group; Infraspinatus Teres Minor Interfascial Plane Block Group

Eligibility Criteria

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

You may qualify if:

• Adults scheduled for elective shoulder arthroscopy
• ASA I-II-III patients
• Patients age between 18-80

You may not qualify if:

• Patients with previously known allergy to local anesthetics.
• Patients with insufficient pulmonary functions (Severe obstruction or restriction in Pulmonary Function Test)
• Patients with ASA IV or higher
• Patients who suffered from any complications related to anesthesia or surgery
• Patients with additional body part injury
• Pregnant or breastfeeding women

Sponsors & Collaborators

• Taksim Egitim ve Arastirma Hastanesi: lead

Study Sites (1)

Taksim Educational and Research Hospital

Istanbul, Beyoğlu, 34433, Turkey (Türkiye)

Location

Related Publications (5)

• Eckmann MS, Bickelhaupt B, Fehl J, Benfield JA, Curley J, Rahimi O, Nagpal AS. Cadaveric Study of the Articular Branches of the Shoulder Joint. Reg Anesth Pain Med. 2017 Sep/Oct;42(5):564-570. doi: 10.1097/AAP.0000000000000652.

  PMID: 28786899 BACKGROUND

• Ma D, Wang R, Wen H, Li H, Jiang J. Cervical erector spinae plane block as a perioperative analgesia method for shoulder arthroscopy: a case series. J Anesth. 2021 Jun;35(3):446-450. doi: 10.1007/s00540-021-02907-x. Epub 2021 Mar 8.

  PMID: 33686465 BACKGROUND

• Ahiskalioglu A, Karapinar YE, Dagci Y, Yayik AM, Ciftci B, Tulgar S. An alternative sonographic approach to infraspinatus-teres minor interfascial plane block: make it easy. Minerva Anestesiol. 2025 Apr;91(4):359-361. doi: 10.23736/S0375-9393.24.18697-X. Epub 2025 Feb 6. No abstract available.

  PMID: 39912574 BACKGROUND

• Desai N. Postoperative analgesia for shoulder surgery. Br J Hosp Med (Lond). 2017 Sep 2;78(9):511-515. doi: 10.12968/hmed.2017.78.9.511.

  PMID: 28898151 BACKGROUND

• Kapukaya F, Ekinci M, Ciftci B, Atalay YO, Golboyu BE, Kuyucu E, Demiraran Y. Erector spinae plane block vs interscalene brachial plexus block for postoperative analgesia management in patients who underwent shoulder arthroscopy. BMC Anesthesiol. 2022 May 12;22(1):142. doi: 10.1186/s12871-022-01687-5.

  PMID: 35550031 BACKGROUND

Central Study Contacts

Canberk Çetinel, MD

CONTACT

+905396996239; canberkc@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Our study is a single-blind study. Outcome Assessor will be masked to performed block type.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 27, 2026
• First Posted: July 7, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2027
• Last Updated: July 7, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF
• Time Frame: Beginning 6 months following publication and ending 5 years after publication.
• Access Criteria: Individual participant data will be available to qualified researchers upon reasonable request to the principal investigator. Requests will be evaluated based on scientific merit and ethical considerations.

Locations

TU (1)