Interscalene vs Infraspinatus-teres Minor (ITM) Interfascial Block in Shoulder Surgery

Kadem Koc60 enrolled

Overview

Postoperative pain is important following arthroscopic shoulder surgery. Postoperative effective pain treatment provides early mobilization and shorter hospital stay.Ultrasound (US)-guided brachial plexus blocks such as interscalen and supraclavicular block are usually performed. Interscalene brachial plexus block is one of the most preferred techniques among these. Due to the phrenic nerve paralysis frequently seen in interscalene block, alternative diaphragm-sparing block techniques have emerged over time. One of these is the Infraspinatus teres minor interfascial block. Infraspinatus teres minor interfascial block can block both the suprascapular nerve and the axillary nerve, which are effective in the innervation of the shoulder, with a single-point injection. The main aim of our study was to show that there is no difference between interscalene block and infraspinatus-teres-minor interfascial block in terms of their effects on postoperative analgesia in patients undergoing arthroscopic shoulder surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

TRIPLE

Enrollment

Conditions

Shoulder Pain Pain, Postoperative Surgical Procedure, Unspecified

Interventions

Preoperative block application (İntersclane Block)OTHER

Before surgery, patients will receive a unilateral interscalene block under ultrasound guidance.

Preoperative block application (Infraspinatus-teres minor interfascial block)OTHER

Before surgery, patients will receive a unilateral infraspinatus-teres minor interfascial block under ultrasound guidance.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists (ASA) classification I-II-III * Scheduled for arthroscopic shoulder surgery under general anesthesia Exclusion Criteria: * history of bleeding diathesis * receiving anticoagulant treatment * infection of the skin at the site of the needle puncture * pregnancy or lactation * patients who do not accept the procedure * Allergy to local anesthetics * Chronic pain syndromes requiring opioid intake

Outcomes

Primary Outcomes

24 hours opioid consumption

morphine consumptions via patient controlled analgesia device for both group will be recorded

Time frame: Time Frame: up to 24 hours

Secondary Outcomes

Sensory and Motor block score

Sensorimotor block assessed every 5 minutes until 30 minutes using a 8-point composite. Block level will be evaluated between 0-8 points score

Time frame: 30 minutes post injection

Numeric rating scale for postoperative pain intensity

Evaluated with a Numerical rating scale (NRS) from 0 to 10. (0=no pain; 10=worst imaginable pain)

Time frame: up to 24 hours (Will be evaluated at 1, 3, 6, 12, 18, 24 hours)

Quality of Recovery - 15 score

The impact of surgical and anesthetic interventions on perioperative quality of life and ability to resume routine life activities will be assessed using the Quality of Recovery (QoR) tool. Each question is scored between 0 and 10. The survey result varies between 0-150 points based on the answers given by the patients. Higher scores indicate better recovery.

Time frame: Postoperative 24th hour