Interscalene versus anterior suprascapular nerve blocks to prevent shoulder pain after open lung surgery
Interscalene Block Versus Anterior Suprascapular Block for Post-Thoracotomy Shoulder Pain: A Randomized Controlled Trial
This trial will test whether adding an ultrasound-guided interscalene block or an anterior suprascapular block to epidural anesthesia reduces shoulder pain after thoracotomy in adults with lung cancer.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 75 (estimated) |
| Ages | 18 Years to 65 Years |
| Sex | All |
| Sponsor | National Cancer Institute, Egypt Academic / other |
| Locations | 1 site (Cairo) |
| Trial ID | NCT07424638 on ClinicalTrials.gov |
What this trial studies
Adults with lung cancer scheduled for elective open thoracotomy will be assigned to receive either an interscalene block plus epidural, an anterior suprascapular block plus epidural, or epidural analgesia alone. The peripheral nerve blocks are performed under ultrasound guidance in the perioperative period and patients are monitored for postoperative pain outcomes and complications. The primary outcome is the frequency of ipsilateral shoulder pain after thoracotomy, with additional measures of analgesic use and recovery recorded during follow-up. The design compares the added benefit of each block to standard epidural care to determine if either technique reduces the common problem of post-thoracotomy shoulder pain.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18–65 with confirmed lung cancer scheduled for elective open-lung surgery, ASA II–III, BMI 18–35 kg/m2, and no contraindications to regional anesthesia.
Not a fit: Patients with pre-existing shoulder symptoms, contraindications to blocks (such as coagulopathy, local infection, or allergy to local anesthetics), severe restrictive or obstructive lung disease, prior thoracotomy, or contralateral diaphragmatic paralysis are unlikely to benefit or may be excluded.
Why it matters
Potential benefit: If successful, adding one of these nerve blocks could lower the rate of post-thoracotomy shoulder pain, improve breathing and physiotherapy participation, and accelerate recovery while possibly reducing opioid needs.
How similar studies have performed: Previous smaller studies and case series suggest interscalene and suprascapular blocks can reduce postoperative shoulder pain, but results are mixed and direct head-to-head comparisons with epidural-only care remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
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.
Where this trial is running
Cairo
- Cairo University — Cairo, Egypt (Recruiting)
Study contacts
- Study coordinator: Mai M Elrawas, MD
- Email: mai.elrawas@nci.cu.edu.eg
- Phone: 00201222177242
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.