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NCT Number: NCT07424638

Interscalene Block Versus Anterior Suprascapular Block for Post-Thoracotomy Shoulder Pain

This study aims to compare the frequency of occurrence of ipsilateral shoulder pain in patients undergoing thoracotomy with ultrasound-guided interscalene block, anterior suprascapular block as adjunct to epidural and epidural block only.

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Key information

Conditions

Interscalene Block Anterior Suprascapular Block Arthralgia Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Shoulder Pain Signs and Symptoms Thoracotomy

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Thoracotomy is one type of surgery associated with challenging pain that needs to be promptly addressed to avoid post-operative respiratory complications and aid in effective postoperative physiotherapy and patient recovery. Epidural analgesia is considered the gold standard for the thoracotomy procedure. Ipsilateral shoulder pain (ISP) following thoracotomy has an incidence ranging from 37% to 85%.

Being so common, this pain needs more attention and proper anticipation, and management. ISP is usually non-responsive to the effects of epidural and paravertebral blocks.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age > 18 years and ≤ 65 years old.
  • American Society of Anesthesiologists (ASA) physical status II-III.
  • Body mass index 18-35 kg/m2.
  • Patients who have a confirmed diagnosis of lung cancer and are scheduled for elective open-lung surgery.

Exclusion criteria

  • Allergy to local anesthetics.
  • Known psychiatric or neurologic disorders.
  • Alcohol or narcotics abuse.
  • Contraindications to thoracic epidural or suprascapular block, or interscalene block, e.g., coagulopathy or local infection.
  • Pre-existing shoulder symptoms.
  • History of previous thoracotomy.
  • Severe restrictive or obstructive pulmonary disease.
  • Pre-existing contralateral diaphragmatic paralysis.

Treatment and study plan

Interscalene block

Other

Patients will receive an ultrasound-guided interscalene block.

Anterior suprascapular block

Other

Patients will receive an ultrasound-guided anterior suprascapular block.

Epidural analgesia

Other

Patients will not receive regional blocks apart from epidural analgesia.

Primary outcomes

  1. Frequency of occurrence of ipsilateral shoulder pain

    Time frame: 72 hours postoperatively

    Frequency of occurrence of ipsilateral shoulder pain will be recorded.

Secondary outcomes

  1. Degree of pain

    Time frame: 72 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be recorded after intensive care unit (ICU) admission then every 6 h postoperative for 72 h.

  2. Mean arterial pressure

    Time frame: 48 hours postoperatively

    Mean arterial pressure will be recorded every 30 minutes and immediately postoperative then every 4 h postoperative for 48 h.

  3. Heart rate

    Time frame: 48 hours postoperatively

    Heart rate will be recorded every 30 minutes and immediately postoperative then every 4 h postoperative for 48 h.

  4. Incidence of complications

    Time frame: 72 hours postoperatively

    Incidence of postoperative complications will be recorded.

  5. Time to first request of rescue analgesia

    Time frame: 72 hours postoperatively

    Rescue analgesia with 5 ml of 0.25% bupivacaine through the epidural catheter (in case of thoracotomy pain). Ketorolac 30 mg I.V. over 50 cc saline for breakthrough shoulder pain (will not exceed 120 mg/day).

  6. Total number of rescue analgesia

    Time frame: 72 hours postoperatively

    Total number of rescue analgesia will be recorded.

  7. Peak Expiratory Flow Rate

    Time frame: 72 hours postoperatively

    Peak Expiratory Flow Rate (PEFR) will be recorded as baseline in holding area before premedication and every 6 h postoperative for 72 h when visual analog scale (VAS) is ≤ 3.

  8. Forced Expiratory Volume in 1 second (FEV1)

    Time frame: 72 hours postoperatively

    Forced Expiratory Volume in 1 second (FEV1) will be recorded preoperative and at day 0, 1, 2 & 3 when visual analog scale (VAS) is ≤ 3.

  9. Forced vital capacity (FVC)

    Time frame: 72 hours postoperatively

    Forced vital capacity (FVC) will be recorded preoperative and at day 0, 1, 2 & 3 when visual analog scale (VAS) is ≤ 3.

  10. Forced Expiratory Volume in 1 second (FEV1) / Forced vital capacity (FVC) ratio

    Time frame: 72 hours postoperatively

    Forced Expiratory Volume in 1 second (FEV1) / Forced vital capacity (FVC) ratio will be recorded preoperative and at day 0, 1, 2 & 3 when visual analog scale (VAS) is ≤ 3.

Study contacts

Contact information is provided by the study sponsor or research team.

Mai M Elrawas, MD

CONTACT

[email protected]

00201222177242

Sponsors and collaborators

Lead sponsor

National Cancer Institute, Egypt

Other

Registry information

Official study title

Interscalene Block Versus Anterior Suprascapular Block for Post-Thoracotomy Shoulder Pain: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Feb 20, 2026
Registry last updated
Feb 24, 2026

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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