About this trial
Arthroscopic shoulder surgery is associated with moderate to severe postoperative pain that may delay recovery and rehabilitation. Interscalene brachial plexus block (ISB) is widely used for postoperative analgesia in shoulder surgery; however, it may be associated with complications such as phrenic nerve paralysis. The serratus posterior superior intercostal plane (SPSIP) block is a recently described fascial plane block that may provide effective analgesia while avoiding some of the limitations of ISB.
This prospective, randomized, double-blind controlled trial aims to compare the analgesic efficacy of ISB and SPSIP block in patients undergoing elective arthroscopic shoulder surgery under general anesthesia. The primary outcome is total postoperative opioid consumption during the first 24 hours after surgery. Secondary outcomes include postoperative pain scores, quality of recovery, time to first rescue analgesia, rescue analgesic requirements, intraoperative opioid consumption, sensory block distribution, motor block characteristics, and block-related complications.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age between 18 and 75 years
ASA physical status I, II, or III
Scheduled for elective arthroscopic shoulder surgery under general anesthesia
Provision of written informed consent
Disqualifiers
Refusal to participate in the study
Coagulopathy
Current anticoagulant therapy
Infection at the block site
Trial design
Parallel
Treatments tested in this trial
Interscalene Brachial Plexus Block
Procedure/SurgeryUltrasound-guided interscalene brachial plexus block performed before induction of general anesthesia for postoperative analgesia in arthroscopic shoulder surgery.
Serratus Posterior Superior Intercostal Plane Block
Procedure/SurgeryUltrasound-guided serratus posterior superior intercostal plane block performed before induction of general anesthesia for postoperative analgesia in arthroscopic shoulder surgery.
Bupivacaine
DrugBupivacaine administered for ultrasound-guided regional anesthesia block.
Treatment groups
Trial outcomes
Primary outcomes
Total Opioid Consumption During the First 24 Postoperative Hours
Comparison of total postoperative opioid consumption between the interscalene brachial plexus block group and the serratus posterior superior intercostal plane block group during the first 24 hours after surgery.
Secondary outcomes
Postoperative Pain Scores
Numeric Rating Scale (NRS) pain scores at rest and during movement, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
Quality of Recovery (QoR-15)
Quality of Recovery-15 (QoR-15) score assessed 24 hours after surgery. Scores range from 0 to 150, with higher scores indicating better postoperative recovery and patient satisfaction.
Intraoperative Remifentanil Consumption
Total remifentanil consumption during surgery.
Time to First Rescue Analgesic Requirement
Time elapsed from the end of surgery to the first rescue analgesic administration.
Sponsors and contacts
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Ferit Yetik
Lead sponsor
Bursa Yuksek Ihtisas Training and Research Hospital
Sponsor institution
Bursa Sehir Hastanesi
Collaborator