Modified Lateral Block of the Suprascapular Nerve: A Safe Approach and How Much to Inject? A Morphological Study

Feigl, Georg; Anderhuber, Friedrich; Dorn, Christian; Pipam, W.; Rosmarin, W.; Likar, Rudolph

doi:10.1016/j.rapm.2007.06.394

Cited by 32 publications

(42 citation statements)

References 14 publications

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“…Too low a volume will result in maldistribution and too high will result in the spread of local anesthetic to the brachial plexus. 9 A recent CT scan study showed that a 10 mL injectate spread to the brachial plexus within the axilla in three out of 33 cadavers. 9 The authors suggested that 5 mL is the adequate volume for injection into the suprascapular fossa.…”

Section: Discussionmentioning

confidence: 99%

“…9 A recent CT scan study showed that a 10 mL injectate spread to the brachial plexus within the axilla in three out of 33 cadavers. 9 The authors suggested that 5 mL is the adequate volume for injection into the suprascapular fossa. One concern of using such a low volume is the maldistribution and potential decrease in the duration of the blockade.…”

Section: Discussionmentioning

confidence: 99%

“…With different approaches, the SSN can be targeted at either the suprascapular notch 1,7 or the suprascapular fossa. 8,9 Major disadvantages of targeting the SSN at the notch are the potential risk of pneumothorax, intravascular injection, injury, or misplacement. 10,11 The precision of the needle tip location can be improved by using imaging techniques, such as ultrasound, fluoroscopy, or computerized tomography (CT) scan guidance.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 The technique is easy to perform and further minimizes the risk of pneumothorax because the needle is directed to the floor of the scapular spine. To ensure that the SSN is blocked, an adequate volume of solution is injected to fill the suprascapular fossa compartment.…”

Section: Discussionmentioning

confidence: 99%

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Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Peng

Wiley

Liang

et al. 2010

Can J Anesth/J Can Anesth

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Purpose Previous work on the ultrasound-guided injection technique and the sonoanatomy of the suprascapular region relevant to the suprascapular nerve (SSN) block suggested that the ultrasound scan showed the presence of the suprascapular notch and transverse ligament. The intended target of the ultrasound-guided injection was the notch. The objective of this case report and the subsequent cadaver dissection findings is to reassess the interpretation of the ultrasound images when locating structures for SSN block. Clinical features A 45-yr-old man with chronic shoulder pain received an ultrasound-guided SSN block using the suprascapular notch as the intended target. The position of the needle was verified by fluoroscopy, which showed the tip of the needle well outside the suprascapular notch. Similar ultrasound-guided SSN blocks were performed in two cadavers. Dissections were performed which showed that the needle tips were not at the suprascapular notch but, more accurately, were close to the SSN but at the floor of the suprascapular fossa between the suprascapular and spinoglenoid notch. Conclusion Our fluoroscopic and cadaver dissection findings both suggest that the ultrasound image of the SSN block shown by the well-described technique is actually targeting the nerve on the floor of the suprascapular spine between the suprascapular and spinoglenoid notches rather than the suprascapular notch itself. The structure previously identified as the transverse ligament is actually the fascia layer of the supraspinatus muscle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Peng

Wiley

Liang

et al. 2010

Can J Anesth/J Can Anesth

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“…Moreover, the Dangoisse, 20 Checcucci, 11 and Feigl 25 techniques are less likely to result in such complications, as they do not access the scapular notch where the suprascapular nerve enters after passing below the upper transverse ligament, in addition to the fact that the needle insertion position is far from the lung.…”

Section: Feigl 25mentioning

confidence: 99%

Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II

Fernandes¹,

Barbosa²,

Sousa³

et al. 2012

Rev. Bras. Reumatol.

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The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifi es the present review (Part II). The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the fi rst part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block. Although rare, complications can occur. When properly indicated, this method should be considered.

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Analgesic effectiveness of nerve block in shoulder arthroscopy: comparison between interscalene, suprascapular and axillary nerve blocks

Lee

Park

Nam

et al. 2012

Knee Surg Sports Traumatol Arthrosc

102

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Modified Lateral Block of the Suprascapular Nerve: A Safe Approach and How Much to Inject? A Morphological Study

Cited by 32 publications

References 14 publications

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Bloc du nerf suprascapulaire par échoguidage: corrélation avec des résultats fluoroscopiques et cadavériques

Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II

Analgesic effectiveness of nerve block in shoulder arthroscopy: comparison between interscalene, suprascapular and axillary nerve blocks

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