Nerve Stimulator Versus Ultrasound-guided Interscalene Block for Shoulder Surgery

Cheju Halla General Hospital53 enrolled

Overview

The investigators compared the postoperative analgesia of nerve stimulator-guided and ultrasound-guided interscalene block after shoulder surgery.

Ultrasound (US)-guided peripheral nerve block has increased in popularity. It has many advantages such as improved success rate, faster onset time, fewer needle passes, shorter performance time, and reduced procedural pain and vascular puncture. However, there is no information about postoperative analgesia. Therefore, the investigators tested whether nerve stimulator (NS) - guided interscalene block was inferior to ultrasound-guided block in terms of duration of postoperative analgesia for shoulder surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Pain

Interventions

NS-guided interscalene blockPROCEDURE

Patients received a standard single injection interscalene block using the modified lateral approach of Borgeat. The interscalene brachial plexus was identified using an insulated needle connected to a nerve stimulator. An insulated needle attached to a nerve stimulator was used to identify the brachial plexus. Placement of the needle was considered adequate if the deltoid, triceps, pectoralis, or biceps muscle motor response was still present at 0.2 - 0.5mA. Ropivacine 0.75% 20ml was used.

US-guided interscalene blockPROCEDURE

Interscalene block is performed under ultrasound guidance. Linear probe is placed on the ipsilateral interscalene groove visualizing the brachial plexus located between anterior and middle scalene muscles. Using in-plane technique, an insulated needle is advanced into the brachial plexus sheath, into which 20 ml of 0.75% ropivacaine is injected

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists physical class I - III patients scheduled to undergo shoulder surgery Exclusion Criteria: * coagulopathy, severe pulmonary disease, neuropathy, contralateral diaphragmatic paresis, allergy to study medications

Locations (1)

Cheju Halla General Hopsital

Jeju City, Jeju Special Governing Province, South Korea

Outcomes

Primary Outcomes

duration of postoperative analgesia

time from completion of local anesthetic injection until the first request for an analgesic

Time frame: at 24h after surgery

Secondary Outcomes

onset time (complete block of sensory and motor nerve)

complete block of sensory and motor nerve

Time frame: until 30min after completion of local anesthetic

patient discomfort (pain score (0 -10) during the procedure)

pain score (0 -10) during the procedure