Anterior Suprascapular and Axillary vs. Interscalene Block for Analgesia and Diaphragmatic Function in Shoulder Surgery

NCT07739303 | Not Yet Recruiting

• 1 other identifier: AEŞH-EK-2026-142
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Shoulder surgeries are among the most frequently performed orthopedic interventions and are often associated with moderate to severe postoperative pain. In these procedures, effective pain management is crucial for early rehabilitation and patient comfort. Peripheral nerve blockade is widely used for postoperative analgesia in shoulder surgery. While the interscalene brachial plexus block is considered the gold standard for pain control, it is frequently associated with unintended phrenic nerve blockade, leading to hemidiaphragmatic paresis. To minimize respiratory complications while maintaining effective analgesia, alternative diaphragm-sparing regional anesthesia techniques, such as the combination of suprascapular and axillary nerve blocks, have been introduced. The aim of this study is to compare the analgesic efficacy and respiratory functions preservation of the ultrasound-guided anterior approach suprascapular combined with axillary nerve block versus interscalene block in patients undergoing shoulder surgery

Conditions

Peripheral Nerve Block; Pain Management; Diaphragm Protective Block; Upper Extremity; Interscalene Block

Keywords

Shoulder Arthroscopy; Interscalene Block; Anterior Suprascapular Block; Axillary Block; Pain Management

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Intensity at Rest

  Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest. Pain assessment at rest will be made at 4 hours after surgery.

  4 hours after surgery.

Secondary Outcomes (8)

• Postoperative Pain Intensity at Rest

  Up to 24 hours

• Postoperative Pain Intensity at Movement

  Up to 24 hours

• Total Postoperative Opioid Consumption

  Up to 24 hours

• Area Under Curve

  At the 24th hour

• Diaphragmatic Excursion

  Baseline (immediately before block performance) and 30 minutes after block performance

Study Arms (2)

Interscalene Block

ACTIVE COMPARATOR

After the patients are placed under monitoring and positioned supine, and appropriate field sterilization is achieved, the ultrasound probe will be positioned transversely at the level of the cricoid cartilage (C6) with the head turned to the contralateral side. Advancing the needle laterally into the interscalene groove between the anterior and middle scalene muscles, 10 mL of local anesthetic (%0.5 bupivacaine ) will be injected between the C5 and C6 nerve roots.

Procedure: Interscalene Block

Combination of Axillary and Anterior Suprascapular Blocks

ACTIVE COMPARATOR

After the patients are placed under monitoring and positioned supine, and appropriate field sterilization is achieved, the ultrasound probe will be positioned transversely in the supraclavicular fossa with the head turned to the contralateral side. Advancing the needle in-plane, 5 mL of local anesthetic (%0.5 bupivacaine) will be injected around the suprascapular nerve as it branches anteriorly from the superior trunk of the brachial plexus. Subsequently, for the axillary nerve block, the patient will be positioned laterally and the ultrasound probe will be placed longitudinally over the posterior aspect of the shoulder. Advancing the needle into the quadrangular space, 5 mL of local anesthetic (%0.5 bupivacaine) will be injected around the axillary nerve adjacent to the posterior circumflex humeral artery.

Procedure: Combination of Axillary and Anterior Suprascapular Blocks

Interventions

Interscalene Block PROCEDURE

Interscalene block will be performed on the patients using 10 mL of 0.5% bupivacaine under ultrasound guidance.

Interscalene Block

Combination of Axillary and Anterior Suprascapular Blocks PROCEDURE

Combined anterior suprascapular(5 ml) and axillary nerve blocks(5 ml) will be performed on the patients using a total of 10 mL of 0.5% bupivacaine under ultrasound guidance.

Combination of Axillary and Anterior Suprascapular Blocks

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 aged between 18 and 65 years
• American Society of Anesthesiologists (ASA) physical status I, II, or III
• Patients scheduled to undergo elective arthroscopic shoulder surgery
• BMI between 18 and 30 kg/m2
• Ability to provide written informed consent

You may not qualify if:

• Known allergy or hypersensitivity to local anesthetics
• Presence of localized infection at the planned injection site
• Severe coagulopathy or active use of anticoagulant medications
• Contralateral phrenic nerve palsy or a diagnosis of severe chronic obstructive pulmonary disease (COPD)
• History of chronic opioid consumption or neuropathic pain

Sponsors & Collaborators

• Ankara Etlik City Hospital: lead

Study Sites (1)

Ankara Etlik City Hospital

Yenimahalle, Ankara, 06170, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

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

Central Study Contacts

İbrahim Topcu

CONTACT

+905437860316; ibrahimtpc78@gmail.com

Musa Zengin

CONTACT

+905307716235; musazengin@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 28, 2026
• First Posted: July 31, 2026
• Study Start (Estimated): August 14, 2026
• Primary Completion (Estimated): December 14, 2026
• Study Completion (Estimated): December 28, 2026
• Last Updated: July 31, 2026

Record last verified: 2026-07

Locations

TU (1)