CompletedPhase 4ACTRN12617001546347

Regional Anaesthesia in Shoulder Arthroscopy: A comparative study

A comparison of efficacy of three techniques for regional anaesthesia in patients undergoing shoulder arthroscopy.

Sponsor

Orthopaedic Research Institute of Queensland

Enrollment

120 participants

Start Date

Aug 1, 2018

Study Type

Interventional

Conditions

Rotator Cuff tear Labral tear (glenoid labrum)Shoulder impingement

Summary

This study aims to compare the efficacy of three methods of regional anaesthesia in shoulder arthroscopy, as well as to compare patient satisfaction with the three methods. People undergoing shoulder arthroscopy will be invited to take part in the trial and will be randomised to one of three groups if they accept. The three groups comprise an Interscalene block, inserted by an anaesthetist; a combined suprascapular & axillary nerve block inserted by an anaesthetist;and the combined block inserted by the treating surgeon during the procedure. Outcomes examined by this study include pain levels after the operation (in the recovery room, the next day & out to a week later), how much pain relieving medication was used and how satisfied the participants were with their experience of regional anaesthesia (through use of a survey form). The findings of this study will be utilised to guide clinical practice in the use of regional anaesthesia in arthroscopic shoulder procedures.

Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 90 Yearss

Inclusion Criteria6

Patients scheduled to undergo shoulder arthroscopy under the care of the investigating surgeons.
Male and female
Age 18-90
Able to provide informed consent
Patients with BMI <40
Patients not currently taking regular opioid analgesics

Exclusion Criteria9

Patients with distorted anatomy that may negatively impact on block insertion
Patients with pre-existing nerve injury/neuropathy affecting the innervation of the upper limb & shoulder.
Patients with a known adverse drug reaction to the medications used in this study
Patients with comorbid medical conditions that would contraindicate block insertion (i.e. ISB in severe COPD)
Patients unable to comply with assessment requirements
Patients with active infection
Patients with BMI >40
Patients who are pregnant or planning on becoming pregnant during the course of the study
Patients unable to provide informed consent

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Interventions

Arm 1 - Interscalene nerve block [brachial plexus block] (ISB), inserted under ultrasound-guidance by a consultant anaesthetist. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL with 0.9% s

Arm 1 - Interscalene nerve block [brachial plexus block] (ISB), inserted under ultrasound-guidance by a consultant anaesthetist. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL with 0.9% saline - Single dose, prior to surgery. - Adherence not applicable, blocks inserted after the patient is under GA Arm 2 - Suprascapular Nerve Block + Axillary Nerve Block (SSNB+ANB), inserted under ultrasound-guidance by a consultant anaesthetist. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL with 0.9% saline - Single dose, prior to surgery. 10mL per nerve. - Adherence not applicable, blocks inserted after the patient is under GA Arm 3 - Suprascapular Nerve Block + Axillary Nerve Block (SSNB+ANB), inserted by arthroscopic guidance by a consultant orthpaedic surgeon. - Ropivacaine 100mg + Clonidine, 75mcg, made up to 20mL 0.9% saline - Single dose, during surgery, 10mL per nerve - Adherence not applicable, blocks inserted after the patient is under GA