Magnesium Sulfate With Standard Combined Costoclavicular-Suprascapular Block for Pain Relief After Shoulder Arthroscopy.

NCT07798115 | Not Yet Recruiting

• 1 other identifier: SHOULDER-MAG-2026-01
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate whether adding magnesium sulfate to a combined costoclavicular and suprascapular nerve block improves postoperative pain control in patients undergoing shoulder arthroscopy. The study will compare pain management outcomes between patients receiving the nerve block with magnesium sulfate and those receiving the nerve block without magnesium sulfate. The main outcome will be the time to first rescue analgesia after surgery.

Conditions

Shoulder Arthroscopy; Postoperative Pain; Regional Anesthesia

Keywords

Costoclavicular Block; Suprascapular Block; Magnesium Sulfate; Postoperative Pain; Shoulder Arthroscopy; Rescue Analgesia

Outcome Measures

Primary Outcomes (1)

• Time to first rescue analgesia after discharge from PACU.

  Time to first rescue analgesia will be measured from the time of discharge from the Post-Anesthesia Care Unit (PACU) until the first administration of rescue analgesic medication for 24 hour due to postoperative pain. Numeric Rating Scale (NRS): Pain intensity was assessed using the 11-point Numeric Rating Scale (NRS), in which 0 = no pain and 10 = the worst pain imaginable.

  From discharge from PACU until 24 hours postoperatively.

Secondary Outcomes (8)

• Postoperative Pain Score Using the Numeric Rating Scale

  At predetermined time points after surgery at ( 2h,6h,12h,18h,24h) during the first 24 hours postoperatively.

• Total Postoperative analgesic Consumption

  First 24 hours postoperatively (one day).

• Duration of sensory block

  From completion of the nerve block until the first administration of rescue analgesia24 hours postoperatively.

• Heart rate

  From baseline before the nerve block until the end of surgery.

• Systolic blood pressure (SBP)

  From baseline before anesthesia induction until 24 hours postoperatively.

Study Arms (3)

Costoclavicular-Suprascapular Block with Normal Saline

EXPERIMENTAL

Participants will receive a single-shot ultrasound-guided costoclavicular brachial plexus block with 5 mL of 0.5% bupivacaine (25 mg) combined with 1.5 mL of 0.9% normal saline, followed by an ultrasound-guided suprascapular nerve block with 10 mL of 0.5% bupivacaine (50 mg) combined with 1.5 mL of 0.9% normal saline.

Drug: Bupivacaine; Drug: Normal Saline (NS); Procedure: Costoclavicular Nerve Block; Procedure: suprascapular nerve block

Costoclavicular-Suprascapular Block with regional Magnesium Sulfate

EXPERIMENTAL

Participants will receive a single-shot ultrasound-guided costoclavicular brachial plexus block with 5 mL of 0.5% bupivacaine (25 mg) combined with 1.5 mL of magnesium sulfate (150 mg), followed by an ultrasound-guided suprascapular nerve block with 10 mL of 0.5% bupivacaine (50 mg) combined with 1.5 mL of magnesium sulfate (150 mg).

Drug: Bupivacaine; Drug: Magnesium sulfate (MgSO4); Procedure: Costoclavicular Nerve Block; Procedure: suprascapular nerve block

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate

EXPERIMENTAL

Participants will receive a single-shot ultrasound-guided costoclavicular brachial plexus block with 5 mL of 0.5% bupivacaine (25 mg) combined with 1.5 mL of 0.9% normal saline, followed by an ultrasound-guided suprascapular nerve block with 10 mL of 0.5% bupivacaine (50 mg) combined with 1.5 mL of 0.9% normal saline. Following the nerve blocks, participants will receive 150 mg of magnesium sulfate diluted in 100 mL of 0.9% normal saline administered intravenously.

Drug: Bupivacaine; Drug: Magnesium sulfate (MgSO4); Drug: Normal Saline (NS); Procedure: Costoclavicular Nerve Block; Procedure: suprascapular nerve block

Interventions

Costoclavicular Nerve Block PROCEDURE

"A single-shot ultrasound-guided costoclavicular nerve block will be performed using 5 mL of 0.5% bupivacaine (25 mg), with either 1.5 mL of magnesium sulfate (150 mg) or 1.5 mL of 0.9% normal saline, according to the assigned study group."

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate; Costoclavicular-Suprascapular Block with Normal Saline; Costoclavicular-Suprascapular Block with regional Magnesium Sulfate

suprascapular nerve block PROCEDURE

"A single-shot ultrasound-guided suprascapular nerve block will be performed using 10 mL of 0.5% bupivacaine (50 mg), with either 1.5 mL of magnesium sulfate (150 mg) or 1.5 mL of 0.9% normal saline, according to the assigned study group."

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate; Costoclavicular-Suprascapular Block with Normal Saline; Costoclavicular-Suprascapular Block with regional Magnesium Sulfate

Bupivacaine DRUG

"Bupivacaine 0.5% will be used as the local anesthetic for ultrasound-guided costoclavicular and suprascapular nerve blocks. A total of 25 mg (5 mL) will be administered for the costoclavicular nerve block and 50 mg (10 mL) for the suprascapular nerve block, for a total dose of 75 mg per participant."

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate; Costoclavicular-Suprascapular Block with Normal Saline; Costoclavicular-Suprascapular Block with regional Magnesium Sulfate

Magnesium sulfate (MgSO4) DRUG

"Magnesium sulfate 150 mg (1.5 mL) will be used as an adjuvant to bupivacaine in each ultrasound-guided nerve block. A total of 300 mg (3 mL) of magnesium sulfate will be administered per participant, with 150 mg added to the costoclavicular nerve block and 150 mg added to the suprascapular nerve block."

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate; Costoclavicular-Suprascapular Block with regional Magnesium Sulfate

Normal Saline (NS) DRUG

"Normal saline (0.9% sodium chloride) will be used as the control adjuvant, with 1.5 mL added to the local anesthetic solution for the costoclavicular nerve block and 1.5 mL added to the local anesthetic solution for the suprascapular nerve block, for a total volume of 3 mL per participant."

Costoclavicular-Suprascapular Block with Intravenous Magnesium Sulfate; Costoclavicular-Suprascapular Block with Normal Saline

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18-50 years
• American Society of Anesthesiologists (ASA) physical status I-II.
• Scheduled for elective outpatient shoulder arthroscopy.
• Ability to understand the study protocol and use the NRS scale.

You may not qualify if:

• Refusal to participate.
• Known allergy or hypersensitivity to local anesthetics or magnesium sulphate.
• Coagulopathy or anticoagulant therapy contraindicating regional anesthesia.
• Local infection at the block site.
• Pre-existing peripheral neuropathy or neurologic deficit involving the operative limb.
• Body mass index (BMI) \> 40 kg/m² (if desired for technical standardization).
• Chronic opioid use or chronic pain syndrome affecting pain assessment.
• Pregnancy or lactation.
• Inability to communicate or complete postoperative assessments.

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Assiut University Hospital

Asyut, Egypt

Location

Related Publications (6)

• Pirotesak S, Fallah N, Alruqaie R, Rodelo K, Asenjo JF, Aliste J. Costoclavicular brachial plexus block for shoulder surgery: a narrative review. Korean J Anesthesiol. 2025 Dec;78(6):513-523. doi: 10.4097/kja.25422. Epub 2025 Aug 4.

  PMID: 40755089 BACKGROUND

• Soleimanpour H, Imani F, Dolati S, Soleimanpour M, Shahsavarinia K. Management of pain using magnesium sulphate: a narrative review. Postgrad Med. 2022 Apr;134(3):260-266. doi: 10.1080/00325481.2022.2035092. Epub 2022 Feb 7.

  PMID: 35086408 BACKGROUND

• Jo Y, Oh C, Lee WY, Chung HJ, Park J, Kim YH, Ko Y, Chung W, Hong B. Randomised comparison between superior trunk and costoclavicular blocks for arthroscopic shoulder surgery: A noninferiority study. Eur J Anaesthesiol. 2022 Oct 1;39(10):810-817. doi: 10.1097/EJA.0000000000001735. Epub 2022 Aug 17.

  PMID: 35975762 BACKGROUND

• Nam YS, Jeong JJ, Han SH, Park SE, Lee SM, Kwon MJ, Ji JH, Kim KS. An anatomic and clinical study of the suprascapular and axillary nerve blocks for shoulder arthroscopy. J Shoulder Elbow Surg. 2011 Oct;20(7):1061-8. doi: 10.1016/j.jse.2011.04.022. Epub 2011 Aug 11.

  PMID: 21839653 BACKGROUND

• Galluccio F, Fajardo Perez M, Yamak Altinpulluk E, Hou JD, Lin JA. Evaluation of Interfascial Plane and Pericapsular Nerve Blocks to the Shoulder Joint: A Preliminary Analysis of Shoulder Anterior Capsular Block. Pain Ther. 2021 Dec;10(2):1741-1754. doi: 10.1007/s40122-021-00326-0. Epub 2021 Oct 20.

  PMID: 34669181 BACKGROUND

• Kay J, Memon M, Hu T, Simunovic N, Duong A, Paul J, Athwal G, Ayeni OR. Suprascapular Nerve Blockade for Postoperative Pain Control After Arthroscopic Shoulder Surgery: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2018 Dec 28;6(12):2325967118815859. doi: 10.1177/2325967118815859. eCollection 2018 Dec.

  PMID: 30627589 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Bupivacaine; Magnesium Sulfate; Saline Solution

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Magnesium Compounds; Inorganic Chemicals; Sulfates; Sulfuric Acids; Sulfur Acids; Sulfur Compounds; Crystalloid Solutions; Isotonic Solutions; Solutions; Pharmaceutical Preparations

Study Officials

• Mohamed Mohamed Abdel Latif, professor

  Assiut University, Faculty of Medicine

  PRINCIPAL INVESTIGATOR

• Eman Ahmed Ismail, professor

  Assiut University, Faculty of Medicine

  STUDY DIRECTOR

• Mohamed Talaat Mohamed, Lecturer

  Assiut University, Faculty of Medicine

  STUDY DIRECTOR

• Ahmed Shaban Abd Elbadea Khalifa, Assistant lecturer

  Assiut University, Faculty of Medicine

  STUDY CHAIR

Central Study Contacts

Ahmed Shaban Abd elbadea Khalifa, Assistant lecturer

CONTACT

+20 1143990130; ahmedshabann144@gmail.com

Mohamed Talaat Mohamed, lecturer

CONTACT

+20 1062012031; tal3t200895@aun.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessors will be blinded to group allocation. The anesthesiologist performing the nerve blocks will be aware of the treatment assignment. The study medications and solutions will be prepared to maintain blinding of participants and outcome assessors.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer of Anesthesiology

Model Details: Participants will be randomly assigned to one of three parallel groups. Group A (control) will receive ultrasound-guided single-shot costoclavicular and suprascapular nerve blocks using bupivacaine with normal saline. Group B will receive the same nerve blocks with magnesium sulfate added to the local anesthetic solution. Group C will receive the same nerve blocks with normal saline, followed by intravenous administration of 150 mg magnesium sulfate diluted in 100 mL normal saline after completion of the nerve blocks. Participants will be followed postoperatively to assess analgesic outcomes, with time to first rescue analgesia as the primary outcome.

Study Record Dates

• First Submitted: August 21, 2026
• First Posted: September 1, 2026
• Study Start: September 1, 2026
• Primary Completion (Estimated): December 30, 2027
• Study Completion (Estimated): March 30, 2028
• Last Updated: September 1, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)