Interscalene and Combined Supra Scapular and Axillary Nerve Blocks in Rotator Cuff Repair

A Randomized Comparison of Inter Scalene and Combined Supra Scapular and Axillary Nerve Blocks for Postoperative Pain Relief in Arthroscopic Shoulder Rotator Cuff Repair

Primary objective of this study is to prospectively compare and evaluate efficacy as well as note side effects of the interscalene block and combined suprascapular and axillary nerve block for ambulatory arthroscopic rotator cuff repair.

Patients having elective arthroscopic rotator cuff repair will be randomized to one of the two groups.

Group 1: This group will receive Interscalene block (ultrasound guided and nerve stimulator aided) followed by a general anesthesia.

Group 2: This group will receive Suprascapular and Axillary nerve block (ultrasound guided and nerve stimulator aided) followed by a general anesthesia.

Performance time, quality and efficacy as well as any side-effects of the blocks will be evaluated in terms of pain scores in recovery room, after 4- 6 hours and the next morning, opioid usage and patient satisfaction.

Primary hypothesis:

• Combined Suprascapular and axillary nerve blocks provide similar postoperative analgesia as compared to interscalene block for arthroscopic rotator cuff repair.

Secondary hypothesis

• Interscalene block is associated with more side effects and complications as compared to suprascapular nerve block and axillary nerve block.

Inclusion Criteria:

• Elective shoulder arthroscopic rotator cuff repair
• ASA I - III (American Society of Anaesthesia Classification)

Exclusion Criteria:

• ASA IV or higher ( American Society of Anaesthesia Classification)
• Obesity: BMI >35
• Narcotic Abuse/ Drug dependency
• Major Neurologic deficits
• Allergy to local anesthetics
• Infection in the site of the puncture
• Mental impairment