Preoperative Ultrasound-Guided Peri- Capsular Nerve Group Block on Postoperative Analgesia After Shoulder Arthroscopic Surgery

Tanta University60 enrolled

Overview

This study aimed to evaluate the analgesic efficacy of preoperative ultrasound-guided peri-capsular nerve group block (PENG) on postoperative analgesia after shoulder arthroscopic surgery.

Postoperative pain control after shoulder surgery is challenging, and poor pain management is invariably reflected in poor outcomes, with longer hospitalization and recovery time. The difﬁculty in reducing pain due to the complexity of shoulder innervation leads to conducting studies to explore selective axillary nerve blocks with a posterior approach or from the axillae. The peri-capsular nerve group (PENG) block is a regional anesthetic technique. It can be effectively and safely applied under ultrasound guidance in shoulder surgery cases for postoperative analgesia. It targets only the sensory branches and not the posterior mechanoreceptors; there is a potential motor-sparing effect which is desirable for better physical therapy, and earlier discharge.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Preoperative Ultrasound-Guided PeriCapsular Nerve Group Block Postoperative Analgesia Shoulder Arthroscopic Surgery

Interventions

SalineDRUG

Patients received sham PENG block (just 1mL saline).

Bupivacaine + DexamethasoneDRUG

Patients received real PENG block (15 mL of bupivacaine 0.25% +0.2mg/mL dexamethasone).

Eligibility

Sex: ALLMin age: 21 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age from 21 to 65 years. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I-III. * Scheduled for unilateral shoulder arthroscopic surgery. Exclusion Criteria: * Patient refusal. * Known hypersensitivity to local anesthetics. * Body mass index\> 35 kg /m2. * Uncooperative or psychiatric patients. * Infection at the injection site. * Coagulation disorder. * Major cardiac, renal, or hepatic diseases.

Locations (1)

Tanta University

Tanta, El-Gharbia, Egypt

Outcomes

Primary Outcomes

Time to the first request of rescue analgesia

Time to the first request of rescue analgesia was recorded from the end of the surgery till first dose of morphine administrated.

Time frame: 24 hours postoperatively

Secondary Outcomes

Degree of pain

The degree of pain was assessed using the Numerical Rating Scale (NRS) Pain score (metric score from 0 to 10 where 0 = no pain and 10 = maximal pain). NRS was recorded at PACU and 2, 4, 6, 8, 12, 16, 20, and 24 h postoperative.

Time frame: 24 hours postoperatively

Total morphine consumption

If patient numeric rating score was more than 3, patients received 3 mg morphine slowly intravenously. Morphine injection was repeated whenever required.

Time frame: 24 hours postoperatively

Data from ClinicalTrials.gov

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