Improving pain in the patients with adhesive capsulitis by comparing the effect of combined shoulder anterior capsular block and intraarticular steroid injection versus intraarticular steroid injection.
Patients acceptance
Age: 41-65 years old
Sex: both sex (males or females).
Physical status: American Society of Anesthesiologist (ASA) І, II.
Shoulder pain due to secondary causes, e.g. acute trauma, fractures, bony deformity, glenohumeral joint pathology, acromioclavicular joint pathology and rotator cuff disorder.
Patient with any contraindications of regional blocks (as coagulopathy or local infection at injection site)
Patients with known history of allergy to the study drugs (bupivacaine and methylprednisolone).
Advanced hepatic, renal, cardiovascular, neurologic and respiratory diseases, uncontrolled diabetes mellitus and thyroid.
Parallel
Group Group Shoulder anterior capsular block (SHAC)
Procedure/Surgerypatients will receive ultrasound guided (SHAC) block combined with intraarticular steroid injection of the affected shoulder joint followed by home exercise program.
Group intraarticular steroid injection (IASI)
Procedure/Surgerypatients will receive intraarticular steroid injection of the affected shoulder joint followed by home exercise program
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
pain intensity
measured by Visual Analogue Scale(VAS) as 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
pain intensity
measured by Visual Analogue Scale (VAS) 10 cm line labelled (0-10), in which 0 presents no pain and 10 represents the worst pain in each participant
Assessment of Shoulder Pain and Disability Index (SPADI)
SPADI contains 13 items that assess two domains - a five item subscale that measures pain and an eight item subscale that measures disability. Each subscale scored 10 ranging from 0 (best) to 10 (worst). It is a self administered, valid questionnaire,
Total amount of rescue analgesia
Total amount of rescue analgesia (ibuprofen)
patient's satisfaction
degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia)
Complications of SHAC block
Complications of SHAC block (local anesthetic toxicity, infection, bleeding)
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