Magnesium Sulfate With Standard Combined Costoclavicular-Suprascapular Block for Pain Relief After Shoulder Arthroscopy.

Analgesic Effect of Additional Magnesium Sulfate to Standard Combined Costoclavicular-suprascapular Block in Shoulder Arthroscopy.

This study aims to evaluate whether adding magnesium sulfate to a combined costoclavicular and suprascapular nerve block improves postoperative pain control in patients undergoing shoulder arthroscopy. The study will compare pain management outcomes between patients receiving the nerve block with magnesium sulfate and those receiving the nerve block without magnesium sulfate. The main outcome will be the time to first rescue analgesia after surgery.

This randomized clinical trial will evaluate the analgesic effect of adding magnesium sulfate to a combined costoclavicular and suprascapular nerve block in patients undergoing shoulder arthroscopy. Shoulder arthroscopy can be associated with significant postoperative pain, and effective regional anesthesia may improve postoperative analgesia and reduce the need for rescue analgesics.

Eligible patients undergoing shoulder arthroscopy will be randomly assigned to receive either a combined costoclavicular and suprascapular nerve block with magnesium sulfate as an adjuvant or the same nerve block without magnesium sulfate. Standardized anesthetic and postoperative analgesic protocols will be applied to both groups.

The primary outcome will be the time to first rescue analgesia after surgery. Secondary outcomes will include postoperative pain scores and other relevant analgesic and safety outcomes during the postoperative observation period.

The study aims to determine whether the addition of magnesium sulfate can prolong the duration of analgesia and improve postoperative pain management following shoulder arthroscopy.

Inclusion Criteria:

• Age between 18-50 years
• American Society of Anesthesiologists (ASA) physical status I-II.
• Scheduled for elective outpatient shoulder arthroscopy.
• Ability to understand the study protocol and use the NRS scale.

Exclusion Criteria:

• Refusal to participate.
• Known allergy or hypersensitivity to local anesthetics or magnesium sulphate.
• Coagulopathy or anticoagulant therapy contraindicating regional anesthesia.
• Local infection at the block site.
• Pre-existing peripheral neuropathy or neurologic deficit involving the operative limb.
• Body mass index (BMI) > 40 kg/m² (if desired for technical standardization).
• Chronic opioid use or chronic pain syndrome affecting pain assessment.
• Pregnancy or lactation.
• Inability to communicate or complete postoperative assessments.