Aims:The aim of our study was to compare the effects of suprascapular nerve block in patients with frozen shoulder and diabetes mellitus unresponsive to intraarticular steroid injections.Settings and Design:Ten patients without improvement of sign and symptoms after intraarticular injections were made a suprascapular nerve block.Methods:Pain levels and active range of movement of patients were recorded at initial attendance and after 1, 4, and 12 weeks. All patients’ simple pain scores, total pain scores, and range of motion of their shoulders were improved significantly after suprascapular nerve block.Statistical Analysis:In this study, the statistical analyses were performed by using the SPSS 8.0 program (SPSS Software, SPSS Inc., USA). To compare pre- and post-injection results of simple pain score, total pain score, shoulder abduction and external rotation, Wilcoxon test was used.Results:Patient's simple pain scores, total pain scores also abduction, external rotation and internal rotation angles were improved significantly after suprascapular nerve block.Conclusion:Effective results after suprascapular nerve blockage was obtained for the treatment of refractory frozen shoulder cases.

O besity is defined by the World Health Organization as a body mass index (BMI) of ≥30 kg/m 2. [1] When the BMI is ≥40 kg m 2 , the patient enters the class of extreme obesity (Class III). Many pathological changes occur; obesity negatively affects all organ systems, led by the respiratory system (obstructive sleep apnea, obesityhypoventilation syndrome, bronchial asthma, pulmonary hypertension), the cardiovascular system (arrhythmia, atherosclerosis, heart failure, coronary artery disease, peripheral vein disease, sudden cardiac death, systemic hypertension, thromboembolism), and the endocrinemetabolic system (diabetes mellitus, hyperinsulinemia, hypothyroidism, insulin resistance, metabolic syndrome). [2] These pathological changes make the management of both general anesthesia and regional anesthesia more difficult in obese patients. In particular, the use of anatomical landmarks to guide the administration of regional anesthesia in the traditional method can become extremely difficult and may lead to failure in this patient population. As a result, in recent years, performing the procedure with ultrasound (US) guidance, a non-invasive method without negative effects, such as radiation, has become popular. This case report describes the administration of spinal anesthesia in an obese patient with the assistance of US due to pulmonary issues.

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