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Subject Area

Anesthesiology

Article Type

Original Study

Abstract

Objectives: This study aimed to compare the ultrasound-guided shoulder block (combined suprascapular nerve block (SSNB) and axillary nerve block (ANB)) with ultrasound-guided erector spinae plane block at the second thoracic vertebral level (high thoracic-ESPB) as an alternative pain management techniques for shoulder arthroscopy.

Background: Effective analgesia of the shoulder is hampered by unfavorable side effects of interscalene brachial plexus block, this forced scientists to discover new alternatives.

Methods: A prospective randomized double-blinded trial for 40 patients, aged 18 to 70, of both sexes, ASAI-II was planned for arthroscopic shoulder surgery under general anesthesia. They divided into 2 equal groups receiving ultrasound guidance blocks using (SonoSite, USA). In Group I, 20 patients (US-high thoracic ESPB) got 30 ml of 0.25% bupivacaine, and in Group II, 20 patients were given 20 ml of 0.5% bupivacaine, 10 for each block (US-SSNB and ANB). The main outcome was the 24-hour analgesics. The secondary outcomes were the visual analog scale (VAS), the time of the first rescue analgesia, postoperative nausea and vomiting, and block performance time. Results: For VAS, HR, and MAP, unfavorable outcomes, patient satisfaction (p=0.66), and the required analgesics, there were statistically insignificant differences between the two groups. The mean performance time in Group I was significantly less than Group II's (P <0.001).

Conclusion: This study concluded that ESPB and shoulder block are similar in managing pain during and after shoulder arthroscopy, except that shoulder block takes longer to perform.

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