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Completed

NCT Number: NCT03352687

Diaphragmatic Paralysis After Ultrasound Block of the Suprascapular Nerve for Shoulder Surgery

Shoulder surgery is a source of intense postoperative pain that justifies the use of opioids. In this context, analgesia provided by locoregional anesthesia (ALR) improves the rehabilitation of patients by reducing the length of hospital stay and morphine consumption. Thus anesthesia of the brachial plexus interscalene (interscalene block or BIS) is considered as the reference technique for the management of post-operative pain after shoulder surgery. It is however provider of hemi-diaphragmatic paralysis (PhD) in nearly 100% of cases. Thus, this technique is usually avoided in patients with respiratory insufficiency. In arthroscopic shoulder surgery, the development of a suprascapular and axillary nerve (SSAX) conjugate block appears to be an effective analgesic alternative in this context.

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Key information

Conditions

Surgery

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Hospital

Toulouse, 31000, France

About this study

Two ultrasound-guided approaches of the suprascapular nerve (anterior and posterior approaches) have been described in the literature. From an anatomical point of view, the anterior approach could expose patients to the risk of ipsilateral PhD by phrenic nerve block secondary to diffusion of the local anesthetic into the supraclavicular region.

By measuring the diaphragm excursion during a sniff test, ultrasound allows reliable and reproducible analysis of the diaphragm function.

No study has evaluated the incidence of PhD after ultrasound block of the suprascapular nerve. Knowing the influence of the approach on this complication could be of major interest in this context.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • to benefit from scheduled arthroscopic surgery of the shoulder under general anesthesia
  • Affiliate or beneficiary of a social security scheme
  • Having signed the informed consent

Exclusion criteria

  • the existence of contralateral diaphragmatic paralysis
  • pre-existing respiratory insufficiency
  • impossibility of performing diaphragmatic ultrasound
  • the patient's refusal
  • the existence of major spontaneous or acquired haemostatic disorders
  • an infection at the point of puncture
  • allergy to local anesthetics
  • Pregnant or likely to be pregnant
  • Patients under protection of the adults (guardianship, curators or safeguard of justice)
  • Patients whose cognitive state does not allow assessment by the scales used

Treatment and study plan

anterior SSAX

Procedure

block of the suprascapular nerve block for shoulder surgery by anterior way

posterior SSAX

Procedure

block of the suprascapular nerve block for shoulder surgery by posterior way

Primary outcomes

  1. change in diaphragmatic excursion

    Time frame: 30 minutes

    measured on ultrasound between the 30th minute after SSAX and the basal state (i.e. prior to regional anesthesia).

    The diaphragmatic excursion is the distance traveled by the diaphragm between the functional residual capacity (CRF) and the forced inspiration during a rapid voluntary sniffing (or "sniff test").

Secondary outcomes

  1. PhD over time

    Time frame: Baseline, 30 minutes, 4 hours and 8 hours

    diaphragmatic excursion by a repeated ultrasound during a "sniff test" in the basal state (ie before regional anesthesia), then 30 minutes, 4 hours and finally 8 hours after realization of the ALR

Other outcomes

  1. Pain evaluation by ENS

    Time frame: Baseline, 4 hours and 24 hours

    Evaluation of the pain by simple numerical scale (ENS from 0 to 10) in the post-interventional surveillance room (SSPI, at the 4th hour) and at the 24th hour

  2. Morphine consumption

    Time frame: until 24 hours

    Evaluation of the morphine consumption in the post-interventional surveillance room (during 24 hours after the SSP)

  3. patient's satisfaction

    Time frame: 24 hours

    Evaluation of the patient's satisfaction with the French Evaluation du Vécu de l'Anesthésie LocoRégionale (EVAN-LR) score

Sponsors and collaborators

Lead sponsor

University Hospital, Toulouse

Other

Registry information

Official study title

Diaphragmatic Paralysis After Ultrasound Block of the Suprascapular Nerve for Shoulder Surgery : Incidence and Influence of the Approach

Acronym: SSParaDia

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Nov 24, 2017
Registry last updated
Dec 17, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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