Rotator Cuff Repair Under Isolated Loco-regional Anesthesia
Rotator Cuff Repair Under Isolated Loco-regional Anesthesia Versus General Anesthesia Combined With Loco-regional Anesthesia: Randomized Controlled Trial of Superiority.
Elsan
80 participants
Nov 13, 2023
INTERVENTIONAL
Conditions
Summary
Damage to the tendons of the shoulder, called rotator cuff, causes pain and loss of strength that may require surgery. This operation is performed under general anesthesia combined with loco-regional anesthesia of the shoulder. Indeed, this loco-regional anesthesia makes it possible to specifically suppress the sensation of pain in the shoulder for several hours after surgery. General anesthesia is produced by injecting drugs intravenously and breathing anesthetic vapors. Repair of the rotator cuff under loco-regional anesthesia alone is performed by several surgeons in France and is recommended by international experts. If blood pressure is artificially lowered during general anesthesia, loco-regional anesthesia alone allows maintenance of blood pressure and real-time clinical assessment since the patient is conscious. The purpose of the research is to compare the blood pressure measured during surgery of patients operated under loco-regional anesthesia alone or associated with general anesthesia, two common practices of surgical teams.
Eligibility
Inclusion Criteria4
- Patient, male or female, aged 18 and over
- Patient with a supraspinatus lesion or supraspinatus and infraspinatus lesions requiring surgery for arthroscopic rotator cuff repair, with a non-retracted or minimally retracted tendon (lower stage or = 2 according to the Patte score) and a muscle with little or no fat infiltration (fatty infiltration less than or = 2 according to the Goutallier classification)
- Affiliated participant or beneficiary of a social security scheme.
- Participant having been informed and having given their free, informed and written consent (at the latest on the day of inclusion and before any examination required by the research).
Exclusion Criteria14
- Patient with a history of surgery for the operated shoulder
- Patient with stage >1 glenohumeral osteoarthritis according to the Samilson classification
- Patient requiring associated subscapularis repair
- Patient with a contraindication to LRA or a contraindication to GA
- Patient wishing a type of anesthesia
- Patient with a contraindication to day surgery
- Patient with neuropathy
- Patients with a history of vagal, emotional or stress-prone discomfort
- Participant whose physical and/or psychological health is severely impaired, which according to the investigator may affect the participant's compliance with the study.
- Patients participating in another research
- Participant in period of exclusion from another research still in progress at the time of inclusion.
- Protected participant: adult under guardianship, curatorship or other legal protection, deprived of liberty by judicial or administrative decision.
- Pregnant, breastfeeding or parturient woman.
- Participant hospitalized without consent.
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Interventions
The operation involves systematic acromioplasty during the supra +/- infraspinatus repair and sometimes requires a tenotomy of the long biceps if it is pathological.
Loco Regional Anesthesia is performed by injecting anesthetic (between 10 and 20 ml of naropeine or chirocaine) into the interscalene nerve block under ultrasound guidance associated to General Anesthesia performed by injection of diprivan and ultiva.
Loco Regional Anesthesia is performed by injecting anesthetic (between 10 and 20 ml of naropeine or chirocaine) into the interscalene nerve block under ultrasound guidance
Locations(4)
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NCT05848375