{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:35:03Z","timestamp":1792265703465,"version":"4.4.0"},"reference-count":26,"publisher":"Brieflands","issue":"6","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["brieflands.com"],"crossmark-restriction":false},"short-container-title":["Anesth Pain Med"],"abstract":"<jats:p>Background: Interscalene brachial plexus block (ISB) remains the gold standard for analgesia in arthroscopic shoulder surgery (ASS). However, ISB is associated with a higher incidence of hemidiaphragmatic paralysis (DP). Objectives: This study compares ultrasound-guided interscalene brachial plexus block (USG-ISB) with a combination of ultrasound-guided pericapsular nerve block (USG-PENB) and superficial cervical plexus block (SCPB) to evaluate analgesic efficacy and the incidence of DP. Methods: In this prospective, triple-blinded randomized trial, 42 American Society of Anesthesiologists (ASA) I - II patients undergoing elective ASS were randomized into two groups after induction of general anesthesia (GA): Group A (ISB, 10 mL 0.25% bupivacaine) or group B [pericapsular nerve block (PENB) 10 mL + SCPB 5 mL 0.25% bupivacaine]. Blocks were performed under ultrasound guidance. The primary outcome was the incidence of DP; secondary outcomes included pain scores, opioid consumption, pulmonary function, and patient satisfaction. Results: Compared with group A, group B demonstrated a delayed time to first request for rescue analgesia (13.24 vs. 8.38 hours; P &lt; 0.001) and reduced 24-hour fentanyl consumption (135.71 vs. 192.86 mcg; P = 0.012). Pulmonary function was significantly better preserved in group B (P &lt; 0.05). The incidence of DP was lower in group B (4.76% vs. 38.1%; P = 0.02). Pain scores at 6, 12, and 18 hours were also lower in group B (P &lt; 0.05). Both groups showed no differences in hypotension, bradycardia, or patient satisfaction. Conclusions: The combination of PENB and SCPB provides analgesia non-inferior to ISB, while significantly reducing the incidence of DP and opioid requirements. For individuals at risk of respiratory impairment, this approach presents a lower-risk alternative without compromising pain control efficacy.<\/jats:p>","DOI":"10.5812\/aapm-165770","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T07:52:48Z","timestamp":1765266768000},"update-policy":"https:\/\/doi.org\/10.5812\/crossmark_update_policy","source":"Crossref","is-referenced-by-count":1,"title":["Interscalene Block Versus Pericapsular Nerve Block and Superficial Cervical Plexus Block for Arthroscopic Shoulder Surgery"],"prefix":"10.5812","volume":"15","author":[{"given":"Amr Arafa","family":"Elbadry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa A.","family":"Abogabal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"Elahwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3819","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"key-A165770REF1-1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520971757"},{"key":"key-A165770REF2-2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.04.009"},{"key":"key-A165770REF3-3","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518759540"},{"key":"key-A165770REF4-4","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12864"},{"key":"key-A165770REF5-5","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny152"},{"key":"key-A165770REF6-6","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12733"},{"key":"key-A165770REF7-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106111"},{"key":"key-A165770REF8-8","first-page":"42","volume":"3","author":"Lanna\u00a0M","year":"2012","journal-title":"Transl Med UniSa."},{"key":"key-A165770REF9-9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2018.12.004"},{"key":"key-A165770REF10-10","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02515-1"},{"key":"key-A165770REF11-11","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13504"},{"key":"key-A165770REF12-12","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjane.2021.05.009"},{"key":"key-A165770REF13-13","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-021-00326-0"},{"key":"key-A165770REF14-14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.110058"},{"key":"key-A165770REF15-15","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-018-0094-7"},{"key":"key-A165770REF16-16","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003306"},{"key":"key-A165770REF17-17","doi-asserted-by":"publisher","DOI":"10.1177\/2374373518795414"},{"key":"key-A165770REF18-18","doi-asserted-by":"publisher","DOI":"10.21608\/zumj.2022.23705.1730"},{"key":"key-A165770REF19-19","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcae175.051"},{"key":"key-A165770REF20-20","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035522"},{"key":"key-A165770REF21-21","doi-asserted-by":"publisher","DOI":"10.22159\/ijcpr.2025v17i2.6045"},{"key":"key-A165770REF22-22","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000002034"},{"key":"key-A165770REF23-23","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002919"},{"key":"key-A165770REF24-24","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000767"},{"key":"key-A165770REF25-25","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13071080"},{"key":"key-A165770REF26-26","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12948"}],"container-title":["Anesthesiology and Pain Medicine"],"original-title":[],"link":[{"URL":"https:\/\/brieflands.com\/journals\/aapm\/articles\/165770","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/brieflands.com\/journals\/aapm\/articles\/165770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T07:52:49Z","timestamp":1765266769000},"score":1,"resource":{"primary":{"URL":"https:\/\/brieflands.com\/journals\/aapm\/articles\/165770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,29]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,11,29]]}},"alternative-id":["8f504cd8dde937b609964b84e91f8080e7cd6f29"],"URL":"https:\/\/doi.org\/10.5812\/aapm-165770","relation":{},"ISSN":["2228-7531"],"issn-type":[{"value":"2228-7531","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,29]]}}}