Effective Pain Management of Interscalene Blocks During Shoulder Surgery

TriHealth Inc.76 enrolled

Overview

Shoulder replacement surgery is recognized as having the potential to cause a considerable amount of postoperative pain. Adequate management of pain after surgery is necessary not only to improve the patient's wellbeing but also to facilitate recovery. Several regional anesthesia techniques are available to combat postoperative pain in the shoulder replacement surgery patient, however, which method provides superior pain relief remains unknown. The purpose of this study is to examine the effectiveness of a continuous interscalene block versus a single shot interscalene block for postoperative pain relief in the shoulder replacement patient. Patients undergoing shoulder replacement surgery will experience more effective pain relief with a continuous interscalene block versus and single shot interscalene block.

This is a prospective randomized controlled trial. 76 patients receiving either primary total shoulder replacement, hemiarthroplasty, or reverse total shoulder replacement will be randomized to a regional anesthesia technique as part of their surgical procedure. 38 patients will receive a single shot interscalene block containing ropivicaine and 38 patients will receive a continuous interscalene block containing ropivicaine.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Primary Osteoarthritis, Unspecified Shoulder

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Surgical candidate for primary total shoulder replacement, hemiarthroplasty, or reverse total shoulder replacement * patient must be 18 years or older and willing to sign and date an Institutional Review Board informed consent form, and * must be able to understand and agree to follow study protocol. Exclusion Criteria: * severe bronchopulmonary disease, * oxygen dependent, * existing nerve injury, * BMI \> 40, * coagulation disorders, * allergy to ropivicaine, * history of drug or alcohol abuse, * American Academy of Anaesthesiologists physical status classification \> lll, * pregnant women.

Outcomes

Primary Outcomes

Pain Score Measure

Patients will be assessed for pain levels by visual analog scale while in the hospital per nursing protocol. Electronic Medical Record will be used to acquire pain scores.

Time frame: participants will be followed for the duration of the hospital stay, an expected average of 3 days

Secondary Outcomes

Morphine Sulfate Equivalence consumption

Total Morphine Sulfate equivalence consumption for each post-operative day while in the hospital will be collected through Electronic medical record.

Time frame: participants morphine sulfate consumption will be gathered for the duration of the hospital stay, an expected average of 3 days

Pain control Satisfaction Score

Patient's post operative pain control satisfaction score will be obtained at the first post operative follow up visit with the physician which is expected to occur on avearage 10 days after surgery

Time frame: 10 day post operative