Investigation Of The Efficacy Of Ultrasound-Guided Superior Trunk Block For Postoperative Analgesia After Proximal Humerus Surgery: A Randomized Controlled Trial
Korgün Ökmen, Gökberk Kürşat Ülker, Durdu Kahraman Yıldız
SBÜ Bursa Yüksek İhtisas EAH
Giriş: Proximal humerus surgery often results in moderate to severe pain, which can hinder postoperative rehabilitation and early mobilization. Traditional regional anesthesia techniques like interscalene brachial plexus block (ISB) are commonly used but come with limitations such as phrenic nerve palsy. The study hypothesizes that the superior trunk block (STB) could offer effective postoperative analgesia with fewer complications in proximal humerus surgery.
Gereç ve Yöntem: The study included 60 patients undergoing proximal humerus surgery. Patients were allocated to two groups. STB group (n:30); ultrasound-guided STB (10ml bupivacaine) and intravenous patient-controlled analgesia (PCA) and control group (n:30); intravenous PCA. Primary Outcome; Postoperative pain was assessed by VAS (at rest) at 1, 2, 6, 12, and 24 hours. Secondary outcome; Tramadol use at 12 and 24 hours postoperatively, subjective respiratory assessment, side effects and use of rescue analgesics.
Bulgular: VAS scores recorded at all time points were significantly lower in the STB group (p<0.001). At 12 and 24 hours, the amount of tramadol consumed was lower in the STB group (p<0.001). When analysing the side effects, no difference was found between the two groups. Horner's syndrome was observed in 2 patients in the STB group.s.
Tartışma ve Sonuç: The study demonstrated that STB provided effective postoperative analgesia with reduced opioid consumption and minimal respiratory complications compared to ISB in shoulder surgeries. STB may be a preferable alternative to ISB, especially in patients where phrenic nerve sparing is a priority. However, anatomical variations and technical challenges in the STB procedure must be addressed to improve its safety and efficacy.
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