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This study aims to compare the serratus posterior superior intercostal plane block and suprascapular nerve block and axillary nerve block for analgesia in shoulder arthroscopic surgery.
Controlling postoperative pain while minimizing opioid administration is particularly important because poor pain control is thought to be responsible for more than 60% of unplanned or prolonged hospitalizations.
Suprascapular nerve block (SSNB) has been proposed based on the anatomic fact that the suprascapular nerve innervates approximately 70% of the shoulder joint, capsule, subacromial space, acromioclavicular joint, and coracoacromial ligament, with the remaining 30% thought to be innervated by the lateral pectoral and axillary nerve.
The combined SSNB and axillary nerve block (ANB) was proposed as a safe alternative to interscalene brachial plexus block (ISB) for providing anesthesia and postoperative analgesia for shoulder surgery.
Serratus posterior superior intercostal plane block (SPSIPB) was described as a novel technique in a case series study of cadavers and five patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group SPSIPB | Experimental | Patients will receive a serratus posterior superior intercostal plane block. |
|
| Group SSSB+ANB | Experimental | Patients will receive suprascapular nerve block + axillary nerve block. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Serratus posterior superior intercostal plane block | Other | Patients will receive a serratus posterior superior intercostal plane block. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to the 1st rescue analgesia | Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administered). | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at 0, 2, 4, 6, 8, 12, 18, and 24 h postoperatively. | 24 hours postoperatively |
| Intraoperative fentanyl consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Suprascapular nerve block + Axillary nerve block | Other | Patients will receive suprascapular nerve block + axillary nerve block. |
|
Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if the heart rate or mean arterial blood pressure is elevated by more than 20% of the baseline. |
| Intraoperatively |
| Total morphine consumption | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS)> 3 to be repeated after 30 min if pain persists until the NRS < 4. | 24 hours postoperatively |
| Incidence of adverse events | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication. | 24 hours postoperatively |
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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