This study aims to compare between Anterior glenoid nerve block, pericapsular nerve group (PENG) block and Interscalene brachial plexus (ISB) block for post-operative pain management in shoulder arthroscopic surgeries
Major surgeries of the shoulder constitute some of the most commonly performed orthopedic procedures. They often result in moderate to severe postoperative pain thereby requiring a multimodal analgesic approach centered around peripheral nerve blocks. Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Interscalene blocks (ISB) are well-studied and established means of providing analgesia following shoulder surgery and are considered the gold standard mode of regional anesthesia and post-operative pain management in shoulder surgeries. A novel technique: pericapsular nerve group (PENG) block can be effectively and safely applied under ultrasound guidance in shoulder surgery cases for postoperative analgesia. In addition, PENG block targets articular branches with less motor effect compared with interscalene brachial plexus block providing anesthetic and analgesic effect with less complication and better and sooner ambulation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
49
Patients will receive an Interscalene brachial plexus block.
Patients will receive an anterior glenoid nerve block.
Patients will receive a pericapsular nerve group (PENG) block.
Ain Shams University
Cairo, Egypt
RECRUITINGTime to the 1st rescue analgesia
Time to the first request for the rescue analgesia (time from the end of surgery to the first dose of pethidine administrated).
Time frame: 24 hours postoperatively
Total pethidine consumption
All patients will receive intravenous pethidine (30mg) on demand \[Visual Analogue Scale (VAS) score ≥3\].
Time frame: 24 hours postoperatively
Degree of pain
Degree of pain will be assessed using visual analogue scale (VAS). Each patient will be instructed about postoperative pain assessment with the VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at 0, 6, 12, and 24 hours postoperatively.
Time frame: 24 hours postoperatively
Length of hospital stay
Length of hospital stay will be recorded from admission till the discharge from hospital.
Time frame: Till discharge from hospital (Up to one week).
Time needed for the patient to freely move the operated limb
Time needed for the patient to freely move the operated limb will be recorded.
Time frame: Postoperatively (Up to one week).
Degree of patients satisfaction
Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)
Time frame: 24 hours postoperatively
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