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Several reports have compared the duration of action of levobupivacaine and ropivacaine as local anesthetic. The most widely used method for sensory function evaluation is though means of a pinprick test. The investigators want to use the novel method of Quantitative Sensory Testing to better evaluate the anesthetic activity. This method used hot and cold sensation to assess small nerve fiber function. The investigators will assess the duration of action of different drugs when used in an inter scalene nerve block in patients scheduled for shoulder surgery.
This study aims to compare the length of the analgesic effect of different local anesthesic solutions, used in an interscalene nerve block. This will be objectified by measuring the changes in small nerve functioning, using quantative sensory testing. Based on the results of a previous study, the investigators reduce the dose of the administered local anesthetic, expecting a similar length of action using these smaller doses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ropivacaine 0.75% | Active Comparator | The investigators administer 5 milliliters of Ropivacaine 0.75% in the inter scalene space |
|
| Levobupivacaine 0.5% | Active Comparator | The investigators administer 5ml of Levobupivacaine 0.5% in the inter scalene space |
|
| Levobupivacaine 0.5% + epinephrin | Active Comparator | The investigators administer 5ml of Levobupivacaine 0.5% + epinephrin 1/200000 in the inter scalene space |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine 0.75% | Drug | The investigators adminster 5ml of Ropivacaine 0.75% in an ultrasound-guided inter scalene nerve block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Length of nerve block measured in longitudinally recorded significant changes in sensory thresholds using quantitative sensory testing | Length of difference in cold and heat pain and sensation measured with quantitative sensory testing | 24 hours after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Need for rescue drugs, as requested by the patient after surgery | 24 hours after intervention | |
| Motor activity block, longitudinally recorded inability to move the blocked limb | 24 hours after intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Luc Serieus, MD | University Hospital, Antwerp | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29725795 | Derived | Sermeus LA, Schepens T, Hans GH, Morrison SG, Wouters K, Breebaart MB, Smitz CJ, Vercauteren MP. A low dose of three local anesthetic solutions for interscalene blockade tested by thermal quantitative sensory testing: a randomized controlled trial. J Clin Monit Comput. 2019 Apr;33(2):307-316. doi: 10.1007/s10877-018-0150-3. Epub 2018 May 3. |
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| Levobupivacaine 0.5% | Drug | The investigators adminster 5ml of Levobupivacaine 0.5% in an ultrasound-guided inter scalene nerve block |
|
|
| Levobupivacaine 0.5% + epinephrin 1/200000 | Drug | The investigators adminster 5ml of Levobupivacaine 0.5% + epinephrin 1/200000 in an ultrasound-guided inter scalene nerve block |
|
|
| Intensity of nerve block, recorded as maximal changes in sensory thresholds using quantitative sensory testing | The difference in threshold of cold and heat pain and sensation measured with quantitative sensory testing | 24 hours after intervention |
| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| D000077554 | Levobupivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D002045 | Bupivacaine |
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