Shoulder DislocationLOW-ST-SDNCT07544485
Ultrasound-Guided Low-Volume Brachial Plexus Block in the Supraclavicular Region for Shoulder Reduction in the Emergency Department
An observational study of Shoulder Dislocation and Joint Dislocation, run by Merian Iselin Klinik at 1 site in Switzerland.
Trial summary
Acute shoulder dislocation is a common and painful condition in the emergency department (ED). Procedural sedation is widely used to facilitate reduction but is associated with potential risks and resource use. Ultrasound-guided regional anesthesia has emerged as an alternative approach. Read more about this study
- Who is it for?
- Ages 15 years and older
- Conditions the study is for
- Shoulder Dislocation, Joint Dislocation
- What is being tested?
- Ultrasound-guided brachial plexus block
- Type of treatment
- Surgery or procedure
- How many people
- 206 participants
- Where
- 1 siteSwitzerland
- Study dates
- 5 Feb 2018to 28 Feb 2024
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 years and older
- All sexes
- Child, Adult, Older adult
Study population: Patients presenting with acute shoulder dislocation to a specialized orthopedic emergency department in a single-center setting. The study population reflects routine clinical practice, including patients treated with ultrasound-guided brachial plexus block or alternative approaches.
Who may be able to join
- Patients presenting with acute shoulder dislocation to the orthopedic emergency department of the Merian Iselin Klinik Basel between February 2018 and February 2024.
- Patients treated within routine clinical care with documented management of shoulder reduction.
Who cannot join
- Patients with incomplete or missing clinical documentation relevant to the study endpoints.
Trial locations and contacts
1 site in 1 country.
Switzerland1 site
Merian Iselin Klinik, Orthopaedic Emergency Department
Basel, Basel, 4009
About this study
Official title: Ultrasound-Guided Low-Volume Brachial Plexus Block in the Supraclavicular Region for Shoulder Reduction in the Emergency Department: A Retrospective Monocentric Observational Study
Acute shoulder dislocation is a common and painful condition in the emergency department (ED). Procedural sedation is widely used to facilitate reduction but is associated with potential risks and resource use. Ultrasound-guided regional anesthesia has emerged as an alternative approach.
This retrospective, monocentric observational study analyzes routinely collected clinical data from an orthopedic ED between February 2018 and February 2024. Adult patients with acute shoulder dislocation are included.
The study evaluates the feasibility, safety, and clinical implementation of low-volume (approximately 5 ml local anesthetic) ultrasound-guided brachial plexus block in the supraclavicular region. Outcomes include procedural success, block-related complications, and temporal trends reflecting the adoption of the technique over time.
Read the detailed description
Acute shoulder dislocation is a frequent orthopedic emergency requiring timely reduction. Procedural sedation and analgesia (PSA) is commonly used but may be associated with risks and increased resource utilization. Ultrasound-guided regional anesthesia of the brachial plexus represents an alternative approach that may allow effective reduction without systemic sedation.
This retrospective, monocentric observational study is based on routinely collected clinical data from the orthopedic emergency department of the Merian Iselin Klinik Basel, Switzerland, covering the period from February 2018 to February 2024. All eligible patients with acute shoulder dislocation were included.
During the study period, ultrasound-guided low-volume brachial plexus block in the supraclavicular region was progressively implemented as part of routine clinical practice. The technique used a standardized low-volume approach (approximately 5 ml local anesthetic).
The aim of this study is to evaluate the feasibility and safety of this approach in a real-world setting, as well as to describe its implementation over time. Particular focus is placed on procedural success, block-related complications, and temporal trends reflecting increasing use and operator experience.
The study further explores the practical aspects of integrating this technique into routine emergency care, including its applicability across a broader group of physicians in a setting with rotating staff and limited case numbers.
The study is conducted in accordance with the Swiss Human Research Act (HRA) as a further use of health-related personal data without consent (Art. 34 HRA). All data are analyzed in coded form without additional interventions or patient contact.
- Conditions
- Shoulder Dislocation, Joint Dislocation
- Being tested
- Ultrasound-guided brachial plexus block
- Keywords
- Ultrasound-guided regional anesthesia, Brachial plexus block, Low-volume nerve block, Supraclavicular approach, Shoulder reduction, Emergency department, Procedural sedation, Retrospective study, Implementation
- Medical subject headings
- Shoulder Dislocation, Joint Dislocations, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound-guided brachial plexus blockProcedure or surgery
Also called Low-volume nerve block, Supraclavicular approach
Ultrasound-guided low-volume brachial plexus block performed in the supraclavicular region as part of routine clinical care for shoulder reduction. The technique was applied according to operator experience and evolving clinical practice over time.
| Study group | Role | What they receive |
|---|---|---|
| Patients with acute shoulder dislocation | Adult patients presenting with acute shoulder dislocation to the orthopedic emergency department between February 2018 and February 2024. Patients were treated according to routine clinical practice, including ultrasound-guided low-volume brachial plexus block or alternative approaches. Receives: Procedure: Ultrasound-guided brachial plexus block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Successful shoulder reduction without procedural sedation
Proportion of patients in whom shoulder reduction was successfully achieved using ultrasound-guided low-volume brachial plexus block without conversion to procedural sedation or general anesthesia.
Measured: During the emergency department visit
Secondary outcomes (3)
Block-related complications
Occurrence of complications associated with ultrasound-guided brachial plexus block as documented in routine clinical records.
Measured: During the emergency department visit
Conversion to procedural sedation
Proportion of cases requiring conversion to procedural sedation after initial attempt with regional anesthesia.
Measured: During the emergency department visit
Temporal trends in technique utilization
Change in the proportion of patients treated with ultrasound-guided brachial plexus block over time, reflecting adoption of the technique and increasing operator experience.
Measured: February 2018 to February 2024
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Apr 2026
- Study start5 Feb 2018
- Primary completion28 Feb 2024
- Study completion28 Feb 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (15)Papers the sponsor has linked to this study.
- Other trials for Shoulder DislocationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 206 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merian Iselin Klinik
- Sponsor type
- University, hospital or other
- Collaborators
- Bethesda Krankenhaus
- Responsible party
- Sponsor
- Investigators
- Eckehart Schöll, MD, Principal investigator, Bethesda Spital, Basel, SwitzerlandMarkus Knupp, MD, Principal investigator, Merian Iselin Klinik, Basel, Switzerland
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07544485
- Sponsor's protocol ID
- LOW-ST-SD_2018-2024
- Acronym
- LOW-ST-SD
- Status last verified
- Apr 2026
- First submitted
- 15 Apr 2026
- Last updated
- 24 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Data are not publicly available due to data protection regulations.
Publications
Schöll E, Litz RJ, et al. Ultrasound-guided brachial plexus block for shoulder reduction. Presented at the Dreiländertreffen der SGUM/DEGUM/ÖGUM, 2024. DOI: 10.1055/s-0044-1789060
Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010 Mar;92(3):542-9. doi: 10.2106/JBJS.I.00450.
PubMed 20194311Leroux T, Wasserstein D, Veillette C, Khoshbin A, Henry P, Chahal J, Austin P, Mahomed N, Ogilvie-Harris D. Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada. Am J Sports Med. 2014 Feb;42(2):442-50. doi: 10.1177/0363546513510391. Epub 2013 Nov 25.
PubMed 24275862Blaivas M, Lyon M. Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED. Am J Emerg Med. 2006 May;24(3):293-6. doi: 10.1016/j.ajem.2005.10.004.
PubMed 16635700Kanji A, Atkinson P, Fraser J, Lewis D, Benjamin S. Delays to initial reduction attempt are associated with higher failure rates in anterior shoulder dislocation: a retrospective analysis of factors affecting reduction failure. Emerg Med J. 2016 Feb;33(2):130-3. doi: 10.1136/emermed-2015-204746. Epub 2015 Jun 25.
PubMed 26113487Dimakopoulos P, Panagopoulos A, Kasimatis G, Syggelos SA, Lambiris E. Anterior traumatic shoulder dislocation associated with displaced greater tuberosity fracture: the necessity of operative treatment. J Orthop Trauma. 2007 Feb;21(2):104-12. doi: 10.1097/BOT.0b013e3180316cda.
PubMed 17304065Dunn MJ, Mitchell R, Souza CD, Drummond G. Evaluation of propofol and remifentanil for intravenous sedation for reducing shoulder dislocations in the emergency department. Emerg Med J. 2006 Jan;23(1):57-8. doi: 10.1136/emj.2004.021410.
PubMed 16373806Diego EBD, Diego ABD, Alcaraz AM, Tomás SN. Experience with regional anesthesia for reduction of shoulder dislocation in the emergency department.
Underhill TJ, Wan A, Morrice M. Interscalene brachial plexus blocks in the management of shoulder dislocations. Arch Emerg Med. 1989 Sep;6(3):199-204. doi: 10.1136/emj.6.3.199.
PubMed 2789584Tezel O, Kaldirim U, Bilgic S, Deniz S, Eyi YE, Ozyurek S, Durusu M, Tezel N. A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction. Am J Emerg Med. 2014 Jun;32(6):549-52. doi: 10.1016/j.ajem.2014.02.014. Epub 2014 Feb 17.
PubMed 24721024Blaivas M, Adhikari S, Lander L. A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department. Acad Emerg Med. 2011 Sep;18(9):922-7. doi: 10.1111/j.1553-2712.2011.01140.x. Epub 2011 Aug 30.
PubMed 21883635Raeyat Doost E, Heiran MM, Movahedi M, Mirafzal A. Ultrasound-guided interscalene nerve block vs procedural sedation by propofol and fentanyl for anterior shoulder dislocations. Am J Emerg Med. 2017 Oct;35(10):1435-1439. doi: 10.1016/j.ajem.2017.04.032. Epub 2017 Apr 14.
PubMed 28460809Harley JD, Harrison AK, Rao AJ. An update on regional anesthesia in shoulder surgery: a narrative review. Ann Jt. 2025 Jun 30;10:29. doi: 10.21037/aoj-24-64. eCollection 2025.
PubMed 40791904Sonawane K. Implementing Precision Regional Anesthesia in an Emergency Setting: Bilateral Upper Trunk Blocks for Shoulder Reduction. Cureus. 2025 Nov 26;17(11):e97859. doi: 10.7759/cureus.97859. eCollection 2025 Nov.
PubMed 41312066Schöll E, Gratza SK, Litz RJ. Bilaterale low-volume Blockade des Plexus brachialis bei beidseitiger antero-inferiorer Schulterluxation. Ultraschall Med - Eur J Ultrasound. September 2024;45(S 01):S42-S42.
Study at a glance
From the registry record, last updated by the sponsor on 24 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasound-Guided Low-Volume Brachial Plexus Block in the Supraclavicular Region for Shoulder Reduction in the Emergency Department: A Retrospective Monocentric Observational Study
- ClinicalTrials.gov ID
- NCT07544485
- Acronym / sponsor ID
- LOW-ST-SD / LOW-ST-SD_2018-2024
- Conditions
- Shoulder Dislocation, Joint Dislocation
- Keywords
- Ultrasound-guided regional anesthesia, Brachial plexus block, Low-volume nerve block, Supraclavicular approach, Shoulder reduction, Emergency department, Procedural sedation, Retrospective study
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 206 participants (actual)
- Lead sponsor
- Merian Iselin KlinikUniversity, hospital or other
- Collaborators
- Bethesda Krankenhaus
- Study start
- 5 Feb 2018 (actual)
- Primary completion
- 28 Feb 2024 (actual)
- Study completion
- 28 Feb 2024 (actual)
- First posted
- 22 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Acute shoulder dislocation is a common and painful condition in the emergency department (ED). Procedural sedation is widely used to facilitate reduction but is associated with potential risks and resource use. Ultrasound-guided regional anesthesia has emerged as an alternative approach.
This retrospective, monocentric observational study analyzes routinely collected clinical data from an orthopedic ED between February 2018 and February 2024. Adult patients with acute shoulder dislocation are included.
The study evaluates the feasibility, safety, and clinical implementation of low-volume (approximately 5 ml local anesthetic) ultrasound-guided brachial plexus block in the supraclavicular region. Outcomes include procedural success, block-related complications, and temporal trends reflecting the adoption of the technique over time.
Detailed description
Acute shoulder dislocation is a frequent orthopedic emergency requiring timely reduction. Procedural sedation and analgesia (PSA) is commonly used but may be associated with risks and increased resource utilization. Ultrasound-guided regional anesthesia of the brachial plexus represents an alternative approach that may allow effective reduction without systemic sedation.
This retrospective, monocentric observational study is based on routinely collected clinical data from the orthopedic emergency department of the Merian Iselin Klinik Basel, Switzerland, covering the period from February 2018 to February 2024. All eligible patients with acute shoulder dislocation were included.
During the study period, ultrasound-guided low-volume brachial plexus block in the supraclavicular region was progressively implemented as part of routine clinical practice. The technique used a standardized low-volume approach (approximately 5 ml local anesthetic).
The aim of this study is to evaluate the feasibility and safety of this approach in a real-world setting, as well as to describe its implementation over time. Particular focus is placed on procedural success, block-related complications, and temporal trends reflecting increasing use and operator experience.
The study further explores the practical aspects of integrating this technique into routine emergency care, including its applicability across a broader group of physicians in a setting with rotating staff and limited case numbers.
The study is conducted in accordance with the Swiss Human Research Act (HRA) as a further use of health-related personal data without consent (Art. 34 HRA). All data are analyzed in coded form without additional interventions or patient contact.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Patients with acute shoulder dislocation | – | Procedure: Ultrasound-guided brachial plexus blockAdult patients presenting with acute shoulder dislocation to the orthopedic emergency department between February 2018 and February 2024. Patients were treated according to routine clinical practice, including ultrasound-guided low-volume brachial plexus block or alternative approaches. |
Who may qualify
- Ages
- 15 years and older
- Sex
- All
- Age groups
- Child, Adult, Older adult
- Study population
- Patients presenting with acute shoulder dislocation to a specialized orthopedic emergency department in a single-center setting. The study population reflects routine clinical practice, including patients treated with ultrasound-guided brachial plexus block or alternative approaches.
Key inclusion criteria (2 listed)
- Patients presenting with acute shoulder dislocation to the orthopedic emergency department of the Merian Iselin Klinik Basel between February 2018 and February 2024.
- Patients treated within routine clinical care with documented management of shoulder reduction.
Key exclusion criteria (1 listed)
- Patients with incomplete or missing clinical documentation relevant to the study endpoints.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultrasound-guided brachial plexus blockAlso: Low-volume nerve block, Supraclavicular approachUltrasound-guided low-volume brachial plexus block performed in the supraclavicular region as part of routine clinical care for shoulder reduction. The technique was applied according to operator experience and evolving clinical practice over time. | Procedure or surgery | Patients with acute shoulder dislocation |
Primary outcome
Successful shoulder reduction without procedural sedation
Time frame: During the emergency department visit
Proportion of patients in whom shoulder reduction was successfully achieved using ultrasound-guided low-volume brachial plexus block without conversion to procedural sedation or general anesthesia.
3 secondary outcomes
Block-related complications
Time frame: During the emergency department visit
Conversion to procedural sedation
Time frame: During the emergency department visit
Temporal trends in technique utilization
Time frame: February 2018 to February 2024
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Apr 2026.
- BackgroundSchöll E, Litz RJ, et al. Ultrasound-guided brachial plexus block for shoulder reduction. Presented at the Dreiländertreffen der SGUM/DEGUM/ÖGUM, 2024. DOI: 10.1055/s-0044-1789060
- Background: PubMed 20194311Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010 Mar;92(3):542-9. doi: 10.2106/JBJS.I.00450.
- Background: PubMed 24275862Leroux T, Wasserstein D, Veillette C, Khoshbin A, Henry P, Chahal J, Austin P, Mahomed N, Ogilvie-Harris D. Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada. Am J Sports Med. 2014 Feb;42(2):442-50. doi: 10.1177/0363546513510391. Epub 2013 Nov 25.
- Background: PubMed 16635700Blaivas M, Lyon M. Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED. Am J Emerg Med. 2006 May;24(3):293-6. doi: 10.1016/j.ajem.2005.10.004.
- Background: PubMed 26113487Kanji A, Atkinson P, Fraser J, Lewis D, Benjamin S. Delays to initial reduction attempt are associated with higher failure rates in anterior shoulder dislocation: a retrospective analysis of factors affecting reduction failure. Emerg Med J. 2016 Feb;33(2):130-3. doi: 10.1136/emermed-2015-204746. Epub 2015 Jun 25.
- Background: PubMed 17304065Dimakopoulos P, Panagopoulos A, Kasimatis G, Syggelos SA, Lambiris E. Anterior traumatic shoulder dislocation associated with displaced greater tuberosity fracture: the necessity of operative treatment. J Orthop Trauma. 2007 Feb;21(2):104-12. doi: 10.1097/BOT.0b013e3180316cda.
- Background: PubMed 16373806Dunn MJ, Mitchell R, Souza CD, Drummond G. Evaluation of propofol and remifentanil for intravenous sedation for reducing shoulder dislocations in the emergency department. Emerg Med J. 2006 Jan;23(1):57-8. doi: 10.1136/emj.2004.021410.
- BackgroundDiego EBD, Diego ABD, Alcaraz AM, Tomás SN. Experience with regional anesthesia for reduction of shoulder dislocation in the emergency department.
- Background: PubMed 2789584Underhill TJ, Wan A, Morrice M. Interscalene brachial plexus blocks in the management of shoulder dislocations. Arch Emerg Med. 1989 Sep;6(3):199-204. doi: 10.1136/emj.6.3.199.
- Background: PubMed 24721024Tezel O, Kaldirim U, Bilgic S, Deniz S, Eyi YE, Ozyurek S, Durusu M, Tezel N. A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction. Am J Emerg Med. 2014 Jun;32(6):549-52. doi: 10.1016/j.ajem.2014.02.014. Epub 2014 Feb 17.
- Background: PubMed 21883635Blaivas M, Adhikari S, Lander L. A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department. Acad Emerg Med. 2011 Sep;18(9):922-7. doi: 10.1111/j.1553-2712.2011.01140.x. Epub 2011 Aug 30.
- Background: PubMed 28460809Raeyat Doost E, Heiran MM, Movahedi M, Mirafzal A. Ultrasound-guided interscalene nerve block vs procedural sedation by propofol and fentanyl for anterior shoulder dislocations. Am J Emerg Med. 2017 Oct;35(10):1435-1439. doi: 10.1016/j.ajem.2017.04.032. Epub 2017 Apr 14.
- Individual participant dataSharing planned: No. Data are not publicly available due to data protection regulations.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Eckehart Schöll, MD principal investigator
Bethesda Spital, Basel, Switzerland
Markus Knupp, MD principal investigator
Merian Iselin Klinik, Basel, Switzerland
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Shoulder Dislocation and Joint Dislocation, run by Merian Iselin Klinik at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Successful shoulder reduction without procedural sedation (time frame: During the emergency department visit). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07544485, which also lists 15 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2026.