Anterior Suprascapular Versus Interscalene Block for Postoperative Analgesia After Arthroscopic Shoulder Surgery in the Outpatient Setting

Condition(s) studied

Investigational drug(s) / intervention(s)

Interscalene Nerve Block: Participants receive an ultrasound-guided interscalene brachial plexus block before shoulder surgery using 10 mL of ropivacaina 0,5%, followed bu standardized general anesthesia and postoperative multimodal analgesia

Anterior suprascapular nerve block: Participants receive an ultrasound-guided anterior suprascapular nerve block before shoulder surgery using 10 mL of ropivacaine 0,5%, followed by standardized general anesthesia and postoperative multimodal analgesia.

Ropivacaine: Ropivacaine 0.5% is used as the local anesthetic for the assigned ultrasound-guided regional anesthesia procedure. Participants receive 10 mL of ropivacaine 0.5% either for interscalene brachial plexus block or for anterior suprascapular nerve block, according to randomized group allocation. The same drug concentration and volume are used in both study groups.

Study summary

Shoulder surgery performed in the outpatient setting can be associated with moderate to severe postoperative pain, especially during the first hours after surgery. Regional anesthesia is commonly used to improve postoperative pain control, reduce opioid use, and support early recovery and safe discharge.

The interscalene block (ISB) is widely considered an effective regional anesthesia technique for shoulder surgery, but it may be associated with adverse effects such as diaphragmatic impairment, dyspnea, hoarseness, Horner syndrome, and prolonged upper limb motor block. The anterior suprascapular nerve block (SSNB-A) is a more selective regional anesthesia technique that may provide comparable postoperative analgesia with fewer block-related adverse effects.

This prospective, randomized, single-blind, noninferiority trial compares SSNB-A with ISB in adult patients undergoing unilateral shoulder surgery in the outpatient setting. All participants receive general anesthesia and the same multimodal analgesic strategy. The primary objective is to determine whether SSNB-A is noninferior to ISB for postoperative pain control, assessed using the Numeric Rating Scale (NRS). Secondary outcomes include quality of recovery measured with the QoR-15 questionnaire, block-related adverse events, sensory and motor block characteristics, and the need for rescue analgesic medication.

Eligibility

Primary outcome measure(s)

• Postoperative pain intensity at 6 hours after surgery — 6 hours after surgery
  Postoperative pain intensity assessed using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. The primary analysis compares NRS pain scores between the anterior suprascapular nerve block group and the interscalene block group to assess noninferiority.

Trial sites (1)

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