Overview
This study is designed to investigate the post-operative analgesic effect of interscalene nerve block or anterior suprascapular nerve block compared to pericapsular nerve group block in patient undergoing elective arthroscopic shoulder surgery.
Description
Shoulder arthroscopy is a common outpatient operation with an increasing number of indications and complexity. Early postoperative pain immediately following shoulder surgery is a major concern and cause of distress for patients and orthopedic surgeons. Adequate pain control is vital for all aspects of the patient's recovery.
Nowadays, several ultrasound -guided regional anesthesia methods are used for postoperative analgesia. Regional techniques such as interscalene and supraclavicular blocks are usually preferred for shoulder analgesia. Interscalene brachial plexus block (ISB) is the gold standard technique in this area.
Suprascapular nerve block (SSB) has been proposed as an alternative to the ISB in providing analgesia for shoulder surgeries as it has a lower likelihood of causing phrenic nerve blockade.
The pericapsular nerve group (PENG) block has been suggested to be safely applied for analgesia and can be part of surgical anesthesia, but alone is not sufficient for anesthesia in shoulder surgery. The block of this area did not cause motor block or pulmonary complications, nor result in muscle laxity, blocking only the shoulder and the upper third of the humerus.
Eligibility
Inclusion Criteria:
- Adult patients.
- ASA class I and II and scheduled for elective shoulder arthroscopy.
Exclusion Criteria:
- Patient who refuses the regional anesthesia technique.
- History of allergy to local anesthetics.
- Local infection at the site of the block.
- History of Pre-existing major organ dysfunction such as hepatic and renal failure.
- History of pre-existing lung disease (COPD, uncontrolled asthma).
- Preexisting upper extremity neurological abnormality or neuropathy.
- Difficulties in comprehending (NRS).
- Chronic opioid users (opioid intake more than 3 months).