Anterior Glenoid Nerve Block Versus Pericapsular Nerve Group Block Versus Interscalene Brachial Plexus Block for Postoperative Pain Management in Shoulder Arthroscopic Surgeries

Major surgeries of the shoulder constitute some of the most commonly performed orthopedic procedures. They often result in moderate to severe postoperative pain thereby requiring a multimodal analgesic approach centered around peripheral nerve blocks.

Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay.

Interscalene blocks (ISB) are well-studied and established means of providing analgesia following shoulder surgery and are considered the gold standard mode of regional anesthesia and post-operative pain management in shoulder surgeries.

A novel technique: pericapsular nerve group (PENG) block can be effectively and safely applied under ultrasound guidance in shoulder surgery cases for postoperative analgesia. In addition, PENG block targets articular branches with less motor effect compared with interscalene brachial plexus block providing anesthetic and analgesic effect with less complication and better and sooner ambulation.

Inclusion criteria

• Age from 18 to 70 years.
• No sex predilection.
• American Society of Anesthesiology (ASA) physical status I-II.
• Undergoing shoulder arthroscopic surgeries.

Exclusion criteria

• Patient's refusal.
• Patients with a history of drug allergies to study drugs.
• Evidence of local infection at the site of injection.
• Inability to cooperate
• Neuromuscular pathology (example: - Multiple Sclerosis)
• Previous trauma or surgery to the shoulder