Randomised comparison between superior trunk and costoclavicular blocks for arthroscopic shoulder surgery: A noninferiority study

BACKGROUND Superior trunk block (STB) provides noninferior analgesia to the interscalene block and reduces the risk of hemidiaphragmatic paralysis (HDP). Recently, supraclavicular spreading has also been shown to occur during costoclavicular block (CCB), presenting as an alternative analgesic technique for shoulder surgery. OBJECTIVE The aim of this study was to determine whether there is a difference in postoperative pain scores and HDP incidence between STB and CCB. DESIGN Prospective randomised controlled trial. SETTING Chungnam National University Hospital in Daejeon from January to July 2021. PATIENTS Seventy patients, aged 20 to 70 years with ASA Physical Status classifications I to III and scheduled for elective arthroscopic rotator cuff repair were recruited. INTERVENTION Ultrasound-guided STB or CCB was performed with 20 ml 0.5% ropivacaine. MAIN OUTCOME MEASURES The primary outcome was the pain score (numeric rating scale, NRS) at 1 h postsurgery. A 1.4 (NRS) noninferiority margin was set a priori. The incidence of HDP, postoperative change of pulmonary function and postoperative opioid use were included as secondary outcomes. RESULTS The pain score was higher in the CCB group compared with the STB group at 1 h postoperatively (median difference, 2; 95% confidence interval (CI), 1 to 3; noninferiority was not demonstrated). Two patients in the CCB group received a rescue interscalene block due to severe po...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Regional anaesthesia Source Type: research