Nerve Block Techniques for Breathing After Shoulder Surgery in Obesity

This trial tests two methods to manage pain after shoulder surgery in people with obesity. It seeks to determine if a special nerve block technique, the Phrenic-Sparing Block Combination, can reduce breathing problems immediately after surgery compared to the usual method. Participants will be randomly assigned to receive either the new or standard pain relief method and will be monitored for breathing and pain levels. The trial seeks individuals with a body mass index (BMI) of 35 or higher who are scheduled for elective shoulder surgery and can perform a simple breathing test. As an unphased trial, it offers participants the chance to contribute to innovative pain management research that could improve surgical outcomes for others with obesity.

The trial information does not specify if you need to stop taking your current medications. However, if you are using chronic opioids over 100 mg per day, you may not be eligible to participate.

Research has shown that the phrenic-sparing block, which includes specific nerve blocks near the shoulder, is generally well-tolerated. One study found that these nerve blocks help prevent breathing problems often associated with traditional methods, resulting in fewer breathing issues after surgery.

Specifically, the study found that these blocks can reduce breathing problems within 24 hours post-surgery, suggesting they are a safer choice for those concerned about breathing issues after shoulder surgery. Additionally, the amount of anesthetic used in these blocks remains within safe limits, further supporting their safety.

Researchers are excited about the nerve block techniques being explored because they offer a new approach to managing breathing difficulties after shoulder surgery, particularly in individuals with obesity. Unlike the standard interscalene block, which can sometimes affect the phrenic nerve and thus the diaphragm, the phrenic-sparing block combination specifically aims to minimize this risk. By using a combination of infraclavicular and distal suprascapular blocks, this technique reduces the likelihood of impacting the phrenic nerve, potentially improving breathing outcomes post-surgery. This innovative approach could provide a safer, more comfortable recovery for patients who are at a higher risk of respiratory complications.

Research shows that a new pain relief method, the phrenic-sparing nerve block, may help manage pain after shoulder surgery. In this trial, participants in one arm will receive this method, which combines infraclavicular and suprascapular nerve blocks. Studies have found that this combination reduces the need for extra pain medication after surgery. It targets specific nerves to control pain without affecting the phrenic nerve, crucial for breathing. This approach aims to manage pain effectively while reducing the risk of breathing problems common with standard methods. Overall, this method offers a good balance of pain control and safety.¹⁵⁶⁷⁸