This randomized controlled trial aims to compare the analgesic efficacy and safety of a Modified Pericapsular Nerve Group (PENG) Block combined with Suprascapular Nerve Block (SSNB) versus Interscalene Brachial Plexus Block (ISB) in adult patients undergoing elective Bankart repair or Latarjet surgery under general anesthesia. Seventy patients will be randomized to receive either Modified PENG plus SSNB or ISB. The primary outcome is postoperative pain intensity measured by the Visual Analog Scale (VAS) at 24 hours. Secondary outcomes include opioid consumption, time to first rescue analgesia, functional recovery, range of motion, and block-related complications including respiratory compromise, motor weakness, Horner syndrome, hoarseness, and local anesthetic systemic toxicity. This randomized controlled trial aims to compare the analgesic efficacy and safety of a Modified Pericapsular Nerve Group (PENG) Block combined with Suprascapular Nerve Block (SSNB) versus Interscalene Brachial Plexus Block (ISB) in adult patients undergoing elective Bankart repair or Latarjet surgery under general anesthesia. Seventy patients will be randomized to receive either Modified PENG plus SSNB or ISB. The primary outcome is postoperative pain intensity measured by the Visual Analog Scale (VAS) at 24 hours. Secondary outcomes include opioid consumption, time to first rescue analgesia, functional recovery, range of motion, and block-related complications including respiratory compromise, motor weakness, Horner syndrome, hoarseness, and local anesthetic systemic toxicity.
• Male or female patients aged 18 to 65 years.
Patients undergoing elective Bankart repair or Latarjet surgery.
American Society of Anesthesiologists (ASA) physical status I or II.
History of allergy to local anesthetics.
None
Parallel
• Modified PENG Block combined with Suprascapular Nerve Block
Procedure/SurgeryUltrasound-guided Modified Pericapsular Nerve Group (PENG) Block combined with Suprascapular Nerve Block (SSNB) performed before induction of general anesthesia. The Modified PENG Block is performed with 20 mL of 0.25% bupivacaine and the SSNB with 10 mL of 0.25% bupivacaine for postoperative analgesia in patients undergoing elective Bankart repair or Latarjet surgery
• Interscalene Brachial Plexus Block
Procedure/SurgeryUltrasound-guided Interscalene Brachial Plexus Block performed before induction of general anesthesia using 20 mL of 0.25% bupivacaine for postoperative analgesia in patients undergoing elective Bankart repair or Latarjet surgery
Visual Analog Scale (VAS) Pain Score at Rest at 24 Hours Postoperatively
Pain intensity at rest will be assessed using the Visual Analog Scale (VAS) for pain, ranging from 0 (no pain) to 10 (worst imaginable pain), 24 hours after surgery. Higher scores indicate worse pain. The primary comparison is between the Modified PENG Block combined with Suprascapular Nerve Block and the Interscalene Brachial Plexus Block.
Visual Analog Scale (VAS) Pain Scores at Postoperative Time Points
Pain intensity will be assessed using the Visual Analog Scale (VAS) for pain, ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate worse pain. Scores will be recorded at multiple postoperative time points.
Total opioid consumption
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