Clinical Research Directory

Comparison of the Analgesic Effects of Catheter-Based Versus Single-Shot Serratus Posterior Superior Intercostal Plane Block in Arthroscopic Shoulder Surgery

Patients undergoing arthroscopic shoulder surgery often experience moderate to severe postoperative pain. Various medical treatments are employed to provide analgesia for these patients. The advancement of regional anesthesia techniques has made possible to both reduce the use of narcotic analgesics and provide long-term pain management benefits. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB) was first described in 2023 by Serkan Tulgar et al. Cadaveric studies and dermatomal analyses in patients have demonstrated its ability to provide analgesia in the back, neck, shoulder, axilla, and lateral thoracic regions. Even though patients undergoing shoulder surgery benefit from the block; once the duration of a single-shot block wears off, they may experience severe pain again. The aim of this study is to investigate the analgesic effects of a single-shot SPSIPB compared to catheter-based SPSIPB with intermittent postoperative bolus administration provided by placing a catheter in this region. The hypothesis of this study: In arthroscopic shoulder surgery, the intermittent bolus administration of the serratus posterior superior intercostal plane block using a catheter will result in lower pain scores, reduced opioid consumption, and improved patient satisfaction compared to single-shot application.

Intravenous Dexamethasone Added to Dexmedetomidine After Superior Trunk Block

This prospective, randomized, placebo-controlled, triple-blind trial will evaluate the effect of adding intravenous dexamethasone to intravenous dexmedetomidine on postoperative analgesia after superior trunk block in adult patients undergoing elective arthroscopic shoulder surgery. All participants will receive ultrasound-guided superior trunk block and standard intravenous dexmedetomidine. Participants will be randomly assigned to receive either intravenous dexamethasone or an equal volume of normal saline placebo before surgery. The main outcome will be the time from completion of the block to the first request for rescue analgesia after surgery. The study will also evaluate postoperative pain scores, rebound pain, opioid consumption, blood glucose levels, hemodynamic changes, postoperative nausea and vomiting, sleep disturbance due to pain, block-related complications, and patient satisfaction.

Erector Spinae Block Versus Shoulder Periarticular Anesthetic Infiltration for Arthroscopic Shoulder Surgery

Arthroscopic shoulder surgery is a common and minimally invasive procedure utilized for different shoulder pathologies, but it is often associated with moderate to severe postoperative pain that may interfere with patients' well-being and course of recovery. By using an effective analgesic technique with few side effects, a patient may experience less pain after surgery, have a shortened hospital stay, and endure less nausea, vomiting, or excessive drowsiness that are associated with the use of opioids to manage postoperative pain. Periarticular infiltration (PAI) with local anesthetic (LA) has been used for shoulder surgery pain management, but the more effective interscalene nerve block (ISNB) is the current gold standard analgesic modality despite risk of significant side effects including diaphragm paralysis and rebound pain. In this study, the investigators want to look at the effectiveness and safety profile of a novel technique for pain management after shoulder surgery that has the potential to provide successful pain relief with minimal risk of side effects. Half of the patients will be randomly selected to receive the novel nerve block called the Erector Spinae Plane (ESP) block while the other half will receive a more standard PAI of local anesthetic to numb the shoulder. Patients' pain intensity and opioid consumption in the post-anesthesia care unit (PACU) as well as during the first 24 hours after surgery will be evaluated. Any complications from the interventions will also be noted. The investigators predict that the ESP block will provide superior analgesia compared to PAI for these shoulder arthroscopy patients.

Diaphragmatic Effects of Combined Infraclavicular Brachial Plexus Block and Suprascapular Nerve Block

This prospective observational study was conducted to evaluate the effects of a combined infraclavicular brachial plexus block and anterior suprascapular nerve block on diaphragmatic function in patients undergoing arthroscopic shoulder surgery. A total of 61 adult patients were enrolled in the study. Diaphragmatic excursion was assessed using ultrasonography both prior to block administration and 30 minutes following the procedure during normal and deep breathing. The primary objective was to assess changes in diaphragmatic excursion and determine the incidence of hemidiaphragmatic paralysis associated with this combined block technique. Secondary outcomes included block performance time, duration of postoperative analgesia, the need for additional intraoperative sedation or analgesia, the occurrence of adverse events, and levels of patient and surgeon satisfaction. The study sought to determine whether this regional anesthesia approach could provide effective anesthesia and analgesia while minimizing impairment of diaphragmatic function.

Interscalene Versus Infraspinatus-Teres Minor Blocks for Arthroscopic Shoulder Surgery

This randomized controlled trial aims to compare the effectiveness of interscalene (ISB) and infraspinatus-teres minor (ITM) blocks for postoperative analgesia in patients undergoing elective arthroscopic shoulder surgery. The primary outcome is total 24-hour opioid consumption. Secondary outcomes include pain scores, hemidiaphragmatic paresis incidence and severity, duration of analgesia, and changes in lung function. Participants are randomized into ISB or ITM groups; blocks are performed under ultrasound guidance. Postoperative pain is managed with patient controlled analgesia(PCA).

The Effects of Regional Anaesthesia Techniques on Hemidiaphragm Paralysis, Postoperative Recovery Quality, Opioid Consumption, and Pain Scores

This study aims to evaluate the effects of ultrasound-guided interscalene, erector spinae plane, costoclavicular, and supraclavicular blocks on hemidiaphragmatic paralysis, postoperative recovery quality, opioid consumption, and pain scores.

Comparative Analgesia and Respiratory Effects of Shoulder Blocks

Interscalene block is widely accepted as the gold-standard regional analgesic technique for pain control after arthroscopic shoulder surgery. However, because this block is performed at the level of the brachial plexus roots, it may be associated with adverse effects such as phrenic nerve blockade and subsequent diaphragmatic dysfunction. These limitations have prompted the search for alternative regional anesthesia techniques that can provide effective postoperative analgesia while preserving respiratory function. The anterior suprascapular block, which covers a broad dermatomal distribution of the shoulder region, has been shown in some studies to provide sufficient analgesia as a standalone technique. In addition, the pericapsular nerve group (PENG) block of the shoulder-applied around the anterior capsule and performed at a distance from critical neurovascular structures that may lead to serious complications-may represent another potential analgesic option following arthroscopic shoulder procedures. Therefore, this study aims to evaluate alternative regional block techniques in comparison with the interscalene block and to contribute to the identification of an optimal analgesic strategy after arthroscopic shoulder surgery.

Bupivacaine Liposome Versus Bupivacaine for Ultrasound-Guided Suprascapular Nerve Combined With Axillary Nerve Block in Analgesia After Arthroscopic Shoulder Surgery

This trial is designed to compare the post-operative analgesic efficacy and safety of liposomal bupivacaine versus plain bupivacaine when both are used for ultrasound-guided combined suprascapular and axillary nerve block in patients undergoing elective arthroscopic shoulder surgery.

Ultrasound Guided Interscalene, Suprascapular and Anterior Glenoid Nerve Blocks on Diaphragmatic Excursion and Analgesia Following Arthroscopic Shoulder Surgery

This study aims to evaluate the diaphragmatic movement and postoperative analgesia following anterior glenoid, suprascapular, and interscalene nerve blocks in patients undergoing elective arthroscopic shoulder surgery.