Comparative Analgesia and Respiratory Effects of Shoulder Blocks

Official title

Analgesic Efficacy and Respiratory Effects of Interscalene, Anterior Suprascapular, and Pericapsular Nerve Group Blocks in Shoulder Arthroscopy

Overview

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.

Interventions

• Procedure Interscalene block
  Interscalene block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.
• Procedure Anterior suprascapular block
  Anterior suprascapular block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.
• Procedure Pericapsular nerve group (PENG) block
  Pericapsular nerve group (PENG) block will be performed, under US guidance, before the surgical operation, and when the patient is placed in the supine position.

Primary outcome measures

• Pain scores [Time frame: First hour after the surgery]

Secondary outcome measures (4)

• Pain scores [Time frame: First 24 hours after surgery]
• Forced vital capacity (FVC) (volume) [Time frame: Perioperative period]
• Forced expiratory flow in 1 s (FEV1) (volume) [Time frame: Perioperative period]
• FEV1/FVC [Time frame: Perioperative period]

Eligibility criteria

Inclusion criteria

• Patients with ASA scores I-II-III
• Patients scheduled for elective arthroscopic shoulder surgery
• Patients who have been informed about the study and have given written consent will be included.

Exclusion criteria

• Those with a known allergy to local anesthetics
• Those with an infection at the application site
• Those with a severe coagulopathy disorder or anticoagulant use
• Those with contralateral phrenic nerve palsy or a serious pulmonary diagnosis
• Those with a history of chronic opioid use or neuropathic pain

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Ankara Etlik City Hospital — Yenimahalle

Identifiers

NCT: NCT07429669 · AEŞH-EK-2026-020

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗