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The aim of this study is to compare the effectiveness of ESPB versus ISB in anesthesia for shoulder arthroscopy
Regional anesthetic techniques can control pain effectively, both at rest and on movement, allowing earlier mobilization without the adverse effects of opioids. Among the various types of regional anesthetic techniques, the interscalene brachial plexus block (ISB) is a gold standard used nerve block technique for postoperative analgesia in patients undergoing shoulder surgery, as it has consistently been shown to significantly control.
the interscalene brachial plexus block (ISB) regional anesthesia offers many advantages over general anesthesia for both arthroscopic and open surgeries of the shoulder it provides excellent intraoperative anesthesia and muscle relaxation' as well as analgesia that continues into the postoperative period
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erector spinae plane block group | Active Comparator | 3ml lidocaine 2% will be used to anesthetize the skin. Using a 20-gauge block needle put in-plane in a cephalad-to-caudad orientation to position the tip into the fascial plane on the deep (anterior) side of the erector spinae muscle, 20 ml bupivacaine 0.5% will be injected. |
|
| Interscalene group | Active Comparator | Using a lateral-to-medial approach, the 25-gauge needle will be inserted into the middle scalene muscle, advanced, and placed immediately lateral to the nerve roots. the needle will be visualize using an ultrasound beam to avoid intraneural and intravascular injections. After confirming negative blood aspiration, we will inject 15 mL of 0.5% bupivacaine around the nerve roots |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erector spinae plane block | Procedure | Using a 20-gauge block needle put in-plane in a cephalad-to-caudad orientation to position the tip into the fascial plane on the deep (anterior) side of the erector spinae muscle, 20 ml bupivacaine 0.5% will be injected |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative fentanyl consumption | Fntanyl will be administered 1 µg/kg IV increments. | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain | numeric rating scale (NRS) (0 represents "no pain" while 10 represents "the worst pain imaginable"). | 24 hours postoperative |
| Rescue analgesia in the form of IV meperidine (0.5 mg/kg) boluses if NRS >3. Time to the 1st rescue analgesic request will be recorded |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Islam Morsy, MD | Contact | 00201093387374 | 139 | eslam.morsy@med.tanta.edu.eg |
| Islam Morsy | Contact | 00201093387374 | 139 | eslam.morsy@med.tanta.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Islam Morsy | Recruiting | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon reasonable request from the principal investigator
For one year after completion of the study
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| Interscalene brachial plexus block | Procedure | Using a lateral-to-medial approach, the 25-gauge needle will be inserted into the middle scalene muscle, advanced, and placed immediately lateral to the nerve roots. the needle will be visualize using an ultrasound beam to avoid intraneural and intravascular injections. After confirming negative blood aspiration, we will inject 15 mL of 0.5% bupivacaine around the nerve roots |
|
| 24 hours postoperative |
| Total amount of rescue analgesic | Rescue analgesia in the form of IV meperidine (0.5 mg/kg) boluses if NRS >3. | 24 hours postoperative |