Korgün ÖKMEN, Gökberk Kürşat ÜLKER, Durdu Kahraman YILDIZ, Aycan Kurtarangil DOĞAN
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(2):435-442
Aim: Moderate to severe pain is common after proximal humerus surgery, often requiring opioid-based analgesia. Superior trunk block (STB), a selective brachial plexus block, has been proposed as an alternative for postoperative pain control. This study aimed to evaluate the analgesic efficacy of STB compared with intravenous patient-controlled analgesia (PCA) following proximal humerus surgery. Methods: This prospective randomized controlled trial included 60 patients undergoing proximal humerus surgery who were randomly assigned to two groups. In the STB group (n = 30), patients received an ultrasound-guided superior trunk block with 10 mL of 0.25% bupivacaine in combination with intravenous PCA. The control group (n = 30) received intravenous PCA alone. The primary endpoint was pain level assessed using a visual analogue scale (VAS) at rest at 1, 2, 6, 12, and 24 hours postoperatively. Secondary endpoints included total tramadol consumption at 12 and 24 hours, subjective respiratory complaints, adverse effects, and the requirement for rescue analgesia. Results: The STB group had significantly lower VAS scores at all time points (p < 0.001). Tramadol consumption at 12 and 24 hours was also significantly lower in the STB group (p < 0.001). Paracetamol was required by 12% of control patients but by none in the STB group (p = 0.007). Adverse effects were similar; two STB patients developed Horner's syndrome, and no respiratory complications were observed. Conclusion: Ultrasound-guided STB provided effective postoperative analgesia for the shoulder and upper arm after proximal humerus surgery, reducing opioid consumption with minimal respiratory side effects.
