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Suprascapular nerve is a mixed motor and sensory peripheral nerve arising from the superior trunk of brachial plexus.The suprascapular nerve runs through the posterior triangle of the neck, anterior of the trapezius muscle and dorsal of the omohyoid muscle, in direction of the scapula. Suprascapular nerve block is performed by anterior and posterior approach. Posterior approach of the suprascapular nerve block has been shown for many years to provide effective analgesia in the shoulder region for the chronic and acute pain. There are studies showing that suprascapular block with anterior approach provides effective analgesia in shoulder arthroscopy.
The aim of our study was to compare anterior and posterior approaches of suprascapular nerve block in terms of analgesic efficacy and patient safety.
This study is a prospective randomized clinical trial will be conducted between July 2022 and June 2023.Participant will divide into two groups as participant who underwent suprascapular nerve block with the anterior approach and participant who underwent suprascapular nerve block with the posterior approach. Bupivacaine 5 ml %0.5 will be injected both group. Diaphragmatic thickness fraction will be evaluated with ultrasound left and right 7.-8. subcostal anterior axillary border with the participant with the semi-sitting position. Diaphragmatic thickness fraction will measure before the block and after 30 minutes the surgery. Participants will administered intravenous morphine patient controlled analgesia for 24 hours stay. The amount of opioid analgesics given in both groups will be determined (in mg). Postoperative 4th, 6th, 12th, 24th hour Visual Analogue Scale scores of the participants and opioid consumptions until that hours will be evaluated. An addition participant will be determined according to the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Posterior suprascapular block | Active Comparator | Suprascapular block performed by posterior approach |
|
| Anterior suprascapular block | Active Comparator | Suprascapular block performed by anterior approach |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Posterior suprascapular block | Procedure | Diaphragmatic thickness fraction will be evaluated in the participant underwent suprascapular block performed by posterior approach |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain at the postoperatively 30 Minutes, 4 Hours, 6Hours, 12Hours, 24Hours | Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel. | Up to 24 hours post-operative |
| Measure | Description | Time Frame |
|---|---|---|
| Diaphragmatic movements | Ratio of diaphragm thickness in end-inspiration and end-expiration measured by ultrasonography | Baseline (Before the block performed) and 30 minutes after the end of surgery |
| Peroperatively opioid analgesic consumption (Remifentanil) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ebru Girgin Dinç, MD | İstanbul Medeniyet University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medeniyet University | Istanbul | 34722 | Turkey (Türkiye) |
After the article is accepted by the journal
After the article is accepted by the journal
After the article is accepted by the journal
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participant with anterior suprascapular block ,group 1 participant with posterior suprascapular block, group 2
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sealed envelope
| Anterior suprascapular block | Procedure | Diaphragmatic thickness fraction will be evaluated in the participant underwent suprascapular block performed by anterior approach |
|
milligram |
| up to postoperative 0 minutes |
| Postoperative opioid analgesic consumption (morphine) | milligram | postoperative 30 minutes |
| Postoperative opioid analgesic consumption (morphine) | milligram | postoperative 4 hours |
| Postoperative opioid analgesic consumption (morphine) | milligram | postoperative 6 hours |
| Postoperative opioid analgesic consumption (morphine) | milligram | postoperative 12 hours |
| Postoperative opioid analgesic consumption (morphine) | milligram | postoperative 24 hours |
| Postoperative pain at postoperative 4 Hours | Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel. | at postoperative 4 Hours |
| Postoperative pain at postoperative 6 Hours | Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel. | at postoperative 6 Hours |
| Postoperative pain at postoperative 12 Hours | Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel. | at postoperative 12 Hours |
| Postoperative pain at postoperative 24 Hours | Visual analog scale (0-10): 0= no pain, 10= the worst pain ever feel. | at postoperative 24 Hours |
| ID | Term |
|---|---|
| D020069 | Shoulder Pain |
| D010149 | Pain, Postoperative |
| D012133 | Respiratory Paralysis |
| ID | Term |
|---|---|
| D018771 | Arthralgia |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D012131 | Respiratory Insufficiency |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D010243 | Paralysis |
| D009422 | Nervous System Diseases |
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