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This prospective randomized controlled study aims to compare the effects of interscalene block, infraspinatus-teres minor interfascial plane block, and a control group on postoperative analgesia and diaphragmatic function in patients undergoing shoulder arthroscopy. A total of 120 patients will be enrolled and allocated into three groups. Postoperative pain scores, opioid consumption, rescue analgesic requirements, and diaphragmatic function will be evaluated and compared among the groups. The study seeks to determine whether the infraspinatus-teres minor interfascial plane block can provide effective postoperative analgesia with less impact on diaphragmatic function compared with interscalene block.
Shoulder arthroscopy is associated with significant postoperative pain. Interscalene block is widely used for analgesia but may impair diaphragmatic function because of phrenic nerve involvement. The infraspinatus-teres minor interfascial plane block has been proposed as an alternative regional anesthesia technique that may provide adequate analgesia while preserving diaphragmatic function. This randomized controlled trial will include 120 adult patients undergoing elective shoulder arthroscopy. Participants will be randomized into three groups: interscalene block, infraspinatus-teres minor interfascial plane block, and control. Pain scores, opioid consumption, time to first rescue analgesia, diaphragmatic excursion measured by ultrasound, and block-related complications will be recorded and analyzed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interscalene Block Group | Experimental | Patients receive ultrasound-guided interscalene brachial plexus block for postoperative analgesia following shoulder surgery. |
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| Infraspinatus-Teres Minor Interfascial Plane Block Group | Experimental | Patients receive ultrasound-guided infraspinatus-teres minor interfascial plane block for postoperative analgesia after shoulder surgery. |
|
| Control Group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound-Guided Interscalene Block | Procedure | Ultrasound-guided interscalene brachial plexus block is performed before induction of anesthesia for postoperative analgesia in patients undergoing shoulder arthroscopy. The block is administered using ultrasound guidance according to institutional practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain Intensity | Postoperative pain intensity assessed using the Visual Analog Scale (VAS) , ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. higher scores indicate greater pain intensity. compared between study groups. | 0, 2,4, 6, 12, and 24 hours after surgery |
| Diaphragmatic Excursion | Comparison of postoperative diaphragmatic excursion measured by ultrasonography between study groups. | 24 hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Participants will be randomized into three parallel groups: interscalene block, infraspinatus-teres minor interfascial plane block, and control group.
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Participants and outcome assessors are blinded to group allocation.
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| Ultrasound-Guided Infraspinatus-Teres Minor Interfascial Plane Block | Procedure | Ultrasound-guided infraspinatus-teres minor interfascial plane block is performed before induction of anesthesia for postoperative analgesia in patients undergoing shoulder arthroscopy. The block is administered using ultrasound guidance according to institutional practice. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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