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NCT Number: NCT06906458

Impact of Paresthesia on Postoperative Neurological Symptoms

In this study, the effect of paresthesia occurring during the interscalene block procedure on the incidence of postoperative neurological symptoms will be investigated. Paresthesia is defined as an abnormal sensation described as "tingling, pinprick, severe pain, or an electric feeling in the arm." The status of postoperative neurological symptoms in patients at the end of the block's effective duration will be assessed through phone interviews, evaluating symptoms such as arm numbness, tingling, abnormal sensations, pain, and weakness.

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Key information

Conditions

Interscalene Block Nervous System Diseases Neurologic Manifestations Pain Pain, Postoperative Paresthesia Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Postoperative Pain Sensation Disorders Signs and Symptoms Somatosensory Disorders

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Ankara Bilkent City Hospital

Ankara, Ankara, Çankaya, 06800, Turkey (Türkiye)

About this study

Our study includes patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status I or II who undergo interscalene nerve block prior to arthroscopic shoulder surgery under general anesthesia. All patients will be fasting according to standard protocol. During the preoperative period, patients' age, comorbidities, gender, body mass index (BMI), ASA scores, and preoperative Quality of Recovery-15 (QoR-15) scores will be recorded.

In the operating room, possible complications related to the block (paresthesia, Horner's syndrome, dyspnea, hoarseness) will be monitored in the preoperative area. During the intraoperative period, data such as pulse, blood pressure, infusion fluids, intraoperative remifentanil requirements, anesthesia duration, and surgical time will be recorded.

In the postoperative period, postoperative pain status, block duration, postoperative nausea and vomiting, need for rescue analgesics and antiemetics, and QoR-15 scores on the first day will be assessed in the recovery room and ward. Additionally, postoperative neurological symptoms and QoR-15 scores will be followed via telephone on the 3rd, 7th, 10th, and 30th days after discharge.

For patients developing postoperative pain, pain intensity will be evaluated using an 11-point numeric rating scale, where 0 indicates no symptoms and 10 represents maximum severity.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • ASA physical status I to II
  • Age range of 18-65 years
  • Patients planned for interscalene nerve block for analgesia prior to arthroscopic shoulder surgery in the beach chair position under general anesthesia

Exclusion criteria

  • body mass index >35 kg/m²)
  • history of drug use
  • Patient's refusal to participate in the study
  • Psychiatric disorders
  • Central nervous system diseases
  • Vestibular disorders
  • Presence of diabetes, neuropathy, and paralysis
  • Pregnancy
  • Open shoulder surgery
  • Allergy to local anesthetics
  • Coagulopathy
  • Severe thrombocytopenia
  • Infection at the puncture site
  • Pre-existing neuropathy in the limb to be operated on
  • Use of opioid and antiemetic medications before surgery
  • Use of dexamethasone
  • Lung disease
  • Low baseline oxygen saturation
  • Patients who cannot cooperate in the postoperative period (e.g., mental retardation, delirium, language acquisition deficiency, etc.)

Treatment and study plan

Paresthesia

Other

Patients experiencing paresthesia during the interscalene nerve block

No paresthesia

Other

Patients not experiencing paresthesia during the interscalene nerve block

Primary outcomes

  1. Paresthesia incidence

    Time frame: Perioperative time

    Paresthesia is considered an abnormal sensation described as "tingling, pinprick, severe pain, or an electric feeling in the arm." When paresthesia occurs, the block procedure will be halted, and the needle will be redirected; local anesthetic will not be administered until the paresthesia resolves, and the occurrence of paresthesia will be recorded.

Secondary outcomes

  1. Incidence of postoperative neurological symptoms

    Time frame: 30 days

    the status of postoperative neurological symptoms will be assessed via telephone by a physician different from the one who performed the block. During the evaluation, symptoms such as arm numbness, tingling, abnormal sensations, pain, and weakness will be considered. Those responding "yes" to any of these symptoms will be classified as patients experiencing postoperative neurological symptoms.

  2. Postoperative pain

    Time frame: 36 hours

    In the postoperative period, patients will be assessed for pain using a 0-10 Numeric Rating Scale (NRS) at rest at 4, 6, 8, 12, 16, and 18 hours, and at both rest and during movement at 24 and 36 hours to record the highest pain scores. The NRS is a scale used for patients to express their pain levels, where 0 represents the absence of pain and 10 represents the most severe pain.

  3. Duration of block effectiveness

    Time frame: 36 hours

    The time (in minutes) until the patient reports a significant increase in pain after the block

  4. Postoperative nausea and vomiting

    Time frame: 36 hours

    Significant nausea, vomiting, and/or need for rescue antiemetics

  5. Rescue analgesic requirement

    Time frame: 36 hours

    Number of additional analgesic applications

  6. Rescue antiemetic requirement

    Time frame: 36 hours

    Number of additional antiemetic applications

  7. intraoperative opioid requirement

    Time frame: intraoperative time

    To maintain the bispectral index (BIS) between 40-60, remifentanil will be initiated and titrated between 0.05-0.25 mcg/kg/min, taking into account a 20% increase in MAP (mean arterial pressure) compared to the initial value and a 15% increase in heart rate compared to the initial value.

  8. Duration of stay in the recovery room

    Time frame: 2 hours

    The time from arrival in the recovery room until the discharge criteria are met

  9. Quality of Recovery-15 (QoR-15) scores

    Time frame: 30 days

    The QoR-15 questionnaire consists of 15 questions rated on a scale of 0 to 10, with a total score assessed out of 150. Results are classified as follows: above 135 is considered "excellent," 122-135 is "good," 90-121 is "fair," and below 90 is "poor.

  10. Horner's syndrome

    Time frame: Perioperative/Periprocedural

    Miosis and ptosis of the ipsilateral pupil during the perioperative period.

  11. Dyspnea

    Time frame: Perioperative/Periprocedural

    Breathing difficulty as described by the patient during the perioperative period.

  12. Hoarseness

    Time frame: Perioperative/Periprocedural

    Voice changes described by the patient during the perioperative period

Sponsors and collaborators

Lead sponsor

Ankara City Hospital Bilkent

Other

Registry information

Official study title

Effect of Paresthesia During Interscalene Block Procedure on the Incidence of Postoperative Neurological Symptoms: A Prospective Observational Clinical Study

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Apr 2, 2025
Registry last updated
Nov 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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