Effectiveness of Field Block Compared With Interscalene Block in Shoulder Surgery
Randomized Control Study: The Effectiveness of Field Block (Local Anesthesia) Compared With Interscalene Block in Shoulder Surgery.
Rabin Medical Center
64 participants
Aug 1, 2024
INTERVENTIONAL
Conditions
Summary
This study will compare two different types of anesthesia used for shoulder surgery. The first method, called an interscalene block, is commonly performed by anesthesiologists and is effective for pain control but may cause side effects such as breathing problems, arm weakness, or discomfort. The second method, called a shoulder field block, is a newer technique performed by orthopedic surgeons that numbs the nerves around the shoulder without affecting breathing. Patients scheduled for shoulder surgery will be randomly assigned to receive either the interscalene block or the shoulder field block. The main goal of the study is to find out whether the shoulder field block provides pain relief that is as effective as the interscalene block, but with fewer side effects. Pain levels, patient satisfaction, length of hospital stay, need for pain medication, and any complications will be recorded and compared between the two groups. The results may help identify a safe and effective alternative anesthesia option for patients undergoing shoulder surgery.
Eligibility
Inclusion Criteria2
- Age between 18 and 75 years
- Scheduled for arthroscopic or open shoulder surgery
Exclusion Criteria8
- Prior surgery or trauma to the shoulder
- Revision shoulder surgery
- Fibromyalgia
- Pregnancy
- Contraindications to regional anesthesia (e.g., allergy to local anesthetics, coagulopathy, local site infection)
- Preexisting neuropathy or myopathy of the surgical limb
- History of chronic opioid use
- Cognitive impairment or inability to understand pain scoring systems (e.g., dementia)
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Interventions
For Shoulder Field Block intervention: This intervention involves a regional anesthesia technique targeting the sensory nerves of the shoulder surgical field: the suprascapular, axillary, and lateral pectoral nerves. The block is performed intraoperatively by the orthopedic surgeon using anatomical landmarks after induction of general anesthesia. A mixture of lidocaine with epinephrine, bupivacaine, and saline is injected into the shoulder area to provide local anesthesia and prolonged postoperative analgesia. This technique aims to spare the phrenic nerve, potentially reducing respiratory complications associated with traditional blocks.
This intervention involves a standard interscalene brachial plexus block performed preoperatively by an anesthesiologist under ultrasound guidance. It anesthetizes the upper roots (C5-C7) of the brachial plexus to provide effective analgesia for shoulder surgery. While effective, it carries risks such as hemi-diaphragmatic paralysis, Horner's syndrome, and motor weakness of the ipsilateral arm due to spread to adjacent nerves.
Locations(1)
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NCT07173894