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November 29, 2025Anesthesiology and Pain MedicineOpen Access

Interscalene Block Versus Pericapsular Nerve Block and Superficial Cervical Plexus Block for Arthroscopic Shoulder Surgery

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Authors

AEAmr Arafa ElbadryTanta UniversityMAMarwa Ahmed AbogabalTanta UniversityLELaila ElahwalTanta University

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Overview

Randomized trial reveals reduced diaphragmatic paralysis and extended analgesia with pericapsular blocks in shoulder surgery patients, indicating a safer respiratory alternative.

Key Points

  • To compare the analgesic efficacy and rate of hemidiaphragmatic paralysis between ultrasound-guided interscalene block and combined pericapsular nerve block with superficial cervical plexus block in arthroscopic shoulder surgery.
  • Prospective, triple-blinded randomized trial of 42 ASA I–II patients undergoing elective arthroscopic shoulder surgery under general anesthesia.
  • Patients were randomized to receive an ultrasound-guided interscalene block (Group A: 10 mL 0.25% bupivacaine) or combined pericapsular nerve block and superficial cervical plexus block (Group B: 10 mL + 5 mL 0.25% bupivacaine).
  • Primary outcome was the incidence of hemidiaphragmatic paralysis; secondary endpoints included pain scores, opioid requirements, pulmonary function, and patient satisfaction.
  • Hemidiaphragmatic paralysis occurred in 4.76% of patients in Group B versus 38.1% in Group A (P = 0.02).
  • Time to first rescue analgesia was longer in Group B (13.24 vs. 8.38 hours; P < 0.001), and 24-hour fentanyl consumption was lower (135.71 vs. 192.86 mcg; P = 0.012).
  • Group B had significantly lower pain scores at 6, 12, and 18 hours alongside superior preservation of pulmonary function (P < 0.05), with no differences in hemodynamic stability or patient satisfaction.

Cite This Study

Elbadry et al. (2025) studied this question.

synapsesocial.com/papers/6aa13990dc6fbdec443d4612https://doi.org/10.5812/aapm-165770
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Diaphragm-sparing efficacy of subparaneural upper trunk block for arthroscopic shoulder surgery2024 · 9 citations
  2. 2Clinical agreement in the American Society of Anesthesiologists physical status classification2018 · 155 citations
  3. 3Suprascapular nerve block is a clinically attractive alternative to interscalene nerve block during arthroscopic shoulder surgery: a meta-analysis of randomized controlled trials2021 · 33 citations
  4. 4Efficacy and safety of suprascapular nerve block combined with axillary nerve block for arthroscopic shoulder surgery: A systematic review and meta-analysis of randomized controlled trials2021 · 32 citations
  5. 5EVALUATION OF THE SAFETY AND EFFICACY OF SUPRACLAVICULAR BLOCK COMBINED WITH SUPERFICIAL CERVICAL BLOCK FOR SHOULDER SURGERY2025 · 1 citations