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Trial protocol evaluates three liposomal bupivacaine concentrations for superior trunk block in rotator cuff repairNew plan tests bupivacaine doses for rotator cuff surgery

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Key Takeaway
Note that no results are available as this is a trial protocol and has not yet been conducted.

This randomized controlled trial protocol describes an investigation into the efficacy of ultrasound-guided superior trunk block (STB) for patients undergoing elective arthroscopic rotator cuff repair. The study will enroll 282 adult patients to evaluate the impact of different concentrations of liposomal bupivacaine on postoperative pain and opioid consumption.

The intervention involves three groups receiving liposomal bupivacaine diluted to 10 mL at concentrations of 66 mg (Group A), 44 mg (Group B), or 33 mg (Group C). The primary outcomes are rest pain Numeric Rating Scale (NRS) scores at 48 h post-surgery and cumulative oral morphine milligram equivalents (MME) consumption within the first 0 to 48 hours post-surgery.

Secondary outcomes include NRS scores at 6, 24, and 72 h, as well as motor function assessments using Muscle Balance Scale, Bromage score, and American Shoulder and Elbow Surgeons (ASES) score. Quality of Recovery-15 (QoR-15) scores will be assessed at 24 and 48 h. The study aims to provide prolonged analgesia without compromising shoulder mobility.

Because this is a protocol, no results regarding safety, tolerability, or efficacy are reported. The trial has not yet been conducted. Clinical application of these findings is currently limited by the lack of available data.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in local anesthetic protocols for shoulder surgery specifically using superior trunk blocks. It relates to previous coverage regarding liposomal bupivacaine, which was shown to reduce 24-hour resting pain scores by 1.04 points in brachial plexus blocks and showed minimal benefit in TAP blocks. While other techniques like PENG blocks or adding adrenaline to bupivacaine have been explored for different procedures, this trial specifically evaluates the dose-response of liposomal bupivacaine in the STB technique.

Patients undergoing elective arthroscopic rotator cuff repair often face significant pain during the first few days of recovery. To address this, researchers are designing a study to see if a specific type of nerve block—the superior trunk block (STB)—can provide lasting relief without affecting how well patients can move their shoulders.

The trial will involve 282 adult patients. They will receive ultrasound-guided STB using liposomal bupivacaine at three different concentrations: 66 mg, 44 mg, or 33 mg. The goal is to determine which dose provides the best balance of pain relief and mobility over a 72-hour period.

Because this is currently a study protocol, no results have been gathered yet. The researchers are looking specifically at rest pain scores and how much morphine patients need after surgery. Once the trial is complete, the data will help doctors decide on the best way to manage patient comfort during recovery.

What this means for you:
A new trial will test three different doses of bupivacaine to find the best way to manage post-surgery shoulder pain.

Common questions

What is being tested in this study?

The study is a protocol designed to test three different doses of liposomal bupivacaine (66 mg, 44 mg, and 33 mg) during an ultrasound-guided superior trunk block. Researchers want to see which dose best manages pain and reduces the need for morphine in patients undergoing rotator cuff surgery.

Who is eligible for this trial?

The study is designed for adult patients who are scheduled for elective arthroscopic rotator cuff repair. The goal is to provide effective, long-lasting pain relief while ensuring the patient can still move their shoulder properly during the first 72 hours after surgery.

Are there results available from this study yet?

No, because this is a trial protocol, it has not been conducted or reported yet. No data on pain scores, morphine use, or safety are currently available. You should speak with your doctor regarding current standard treatments for shoulder surgery pain.

Study Details

Study typeRct
EvidenceLevel 2
PublishedDec 2026
View Original Abstract ↓
BACKGROUND: Shoulder arthroscopy frequently causes severe postoperative pain that may impede recovery. Liposomal bupivacaine provides prolonged analgesia, and ultrasound-guided superior trunk block (STB) offers comparable analgesia to interscalene block with a lower risk of hemidiaphragmatic paralysis. However, the optimal concentration of liposomal bupivacaine for STB remains unknown. METHODS: This randomized, double-blind, controlled trial will enrol 282 adult patients scheduled for elective arthroscopic rotator cuff repair. Patients will be randomly allocated (1:1:1) to receive ultrasound-guided STB with liposomal bupivacaine 66 mg (Group A), 44 mg (Group B) or 33 mg (Group C), each diluted to 10 mL. The co-primary outcomes are (1) rest pain Numeric Rating Scale (NRS) score at 48 h post-surgery and (2) cumulative oral morphine milligram equivalents (MME) consumption within 0-48 h after surgery. Secondary outcomes include rest pain NRS scores at 6, 24 and 72 h; motor function assessed by Muscle Balance Scale, Bromage score and American Shoulder and Elbow Surgeons (ASES) score at 6, 24, 48 and 72 h; and Quality of Recovery-15 (QoR-15) score at 24 and 48 h. DISCUSSION: This study will provide evidence on the optimal concentration of liposomal bupivacaine for STB in arthroscopic shoulder surgery, aiming to achieve effective and prolonged analgesia without compromising shoulder mobility.
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