This study aimed to compare the efficacy of high thoracic-ESPB with shoulder block as analgesic options for arthroscopic shoulder surgery. Primary outcome: • 24-hour analgesic consumption. Secondary outcomes: * Postoperative pain evaluated by: Visual Analogue Pain Scale (VAS). * Time to first rescue analgesia and total postoperative consumption of analgesia. * Effect of the block on Hemodynamics. * Adverse effects in the form of postoperative nausea and vomiting (PONV). * Patient satisfaction.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
High Thoracic-ESPB The patient was placed in the lateral decubitus. The transverse process of T2 was identified. After negative aspiration, hydro dissection using 2 mL of saline was performed. Eventually, 30 mL of the LA bupivacaine 0.25% and epinephrine 5 µg/ mL was injected.
Shoulder Block Suprascapular nerve block (SSNB) approach: The needle was progressed in plane from medial to lateral after local infiltration of the skin with 1% lidocaine. We directed the needle towards the lateral side of the supra-spinous fossa if the neuro-vascular bundle was not evident. After careful aspiration, 10 ml of 0.5% bupivacaine was injected under the supraspinatus muscle. Axillary nerve block technique: The nerve approach had been described in plane from cranial to caudal. After local infiltration of the skin with 1% lidocaine, the needle tip must be visualized within the fascia below the teres minor muscle and just above the PCHA. After cautious aspiration, 10 ml of 0.5% bupivacaine was injected on the posterior aspect of the humerus.
MenoufiaU
Cairo, Egypt
24-hour analgesic consumption.
Total consumptive dose of Morphine. Patients started acetaminophen (1 g PO) before surgery. Acetaminophen infusion continued postoperatively at a dose of 1 g/6 hours. Later, 75 mg diclofenac sodium was also given intravenously twice a day, in combination with 40 mg pantoprazole once. Rescue analgesia of 2.5 mg morphine was given intravenously if the postoperative Visual Analogue Scale score was \> 3 or the patient requested additional analgesia.
Time frame: 24 hours.
Visual Analogue Scale.
The pain control target was considered at Visual Analogue Scale score (VAS) \< 4, where VAS score of 0 means no pain and VAS score of 10 means the worst pain imaginable. Postoperative pain evaluated by: Visual Analogue Pain Scale (VAS). Time to first rescue analgesia and total postoperative consumption of analgesia. Effect of the block on Hemodynamics. Adverse effects in the form of postoperative nausea and vomiting
Time frame: ● Every 0.5 hour for next 2 hours. ● Every 2 hours for next 6 hours. ● Every 6 hours for remaining 24 hours post-operatively.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.