Abstract
Background Post shoulder arthroscopic pain is significant. Interscalene block is the standard technique for controlling pain, but the high incidence of complications limits this technique. Our aim was to evaluate the incidence of hemidiaphragmatic paralysis after selective superior trunk block compared to conventional interscalene block as regards.Methods A randomized controlled trial was conducted in which 68 patients who were scheduled for shoulder arthroscopy were divided into two equal groups. The interscalene group received ultrasound (US) guided interscalene block and the superior trunk group received US guided selective superior trunk block. Performance time, block quality, hemidiaphragmatic movement, and incidence of complications were assessed and recorded.Results The incidence of hemidiaphragmatic movement in interscalene group was significantly greater than that in the selective superior trunk block (76.5% vs 38.2%), and it was completely affected in 44.1% of the interscalene group compared to 11.8% of the selective superior trunk block group. The performance duration (min) was significantly greater in the selective superior trunk group than in the interscalene group (6.97 ± 0.67) vs (6.48 ± 0.69) respectively.Conclusions Although US-guided interscalene and selective superior trunk blocks provided an equipotent postoperative analgesic effect, selective superior trunk block was associated with a significantly lower incidence of hemidiaphragmatic paralysis.Trial registration: This prospective double-blinded randomized control trial was performed at Menoufia University Hospital after obtaining approval from its ethics committee (IRB approval number 4/2022 ANET1-1) and was registered under www.pactr.org (PACTR 202203695753410) with registration number (PACTR 202203695753410), and the registration date was at 11/02/2022. This trial was conducted in accordance with the Reporting Trials (CONSORT) guideline Consolidated Standards.