Post-operative analgesia for shoulder arthroscopic surgeries: A comparison between inter-scalene block and shoulder block

Abstract

Background and Aims: Shoulder arthroscopic surgeries can produce intense post-operative pain. Inter-scalene block (ISB) provides good analgesia after shoulder surgery, but concerns over its associated risks have prompted the search for alternatives. Shoulder block (SHB), which includes suprascapular block along with axillary nerve (AN) block, was recently proposed as an alternative to ISB, but evidence of its efficacy is conflicting. The aim of our study was to compare SHB with ISB in shoulder surgery for post-operative analgesia. Methods: A total of 76 patients scheduled for shoulder arthroscopic surgery were equally divided into 2 groups of 38 patients each: ISB group and SHB group. Both the nerve blocks were achieved by using ultrasound and a nerve stimulator. Visual analogue scale (VAS) scores were evaluated at 1, 4, 6, 12 and 24 h post-operatively. The time to first analgesia request, total analgesic requirement for 24 h post-operatively, patient satisfaction and any complications were recorded. Results: SHB provided equivalent analgesia to ISB in terms of post-operative VAS scores. Time to first analgesic request was 6.2 ± 1.3 h in ISB group and 5.9 ± 1.2 h in SHB group, which was not statistically significant. Complications like subjective dyspnoea and weakness of arm were significantly higher in ISB group compared to SHB group. Patient satisfaction scores were also significantly higher in SHB group compared to ISB group. Conclusion: SHB is as effective as ISB for post-operative pain relief and with fewer complications due to selective blockade of suprascapular and axillary nerves.

Comparison of Ultrasound-Guided Supra-scapular Plus Axillary Nerve Block with Interscalene Block for Postoperative Pain Management in Arthroscopic Shoulder Surgery; A Double-Blinded Randomized Open-Label Clinical Trial

“…The average time of the first analgesic request and its prescribed dosage on the first post-operation day showed no significant difference between the two groups. These findings are comparable with most earlier studies (12)(13)(14)(15)(16).…”

Comparison between analgesic effect of ultrasound guided interscalene block versus shoulder block versus suprascapular nerve block for arthroscopic shoulder surgery: A randomized controlled trial

“…The usual clinic values at 30 and 90 minutes post-op were considerably higher in the control and intra-articular groups than in the ISPB group. Our findings regarding VAS are confirmed by a research by Pani et al [18] , who compared SHB and ISB for postoperative analgesia following shoulder surgery. A total of 76 cases were split into two groups of 38 cases each for shoulder arthroscopy procedures; the ISB group and the SHB group.…”

Selective blockade of supraclavicular nerves and upper trunk of brachial plexus “The SCUT block” towards a site-specific regional anaesthesia strategy for clavicle surgeries - A descriptive study

“…The studies describing the UT or interscalene injections for shoulder anaesthesia and analgesia, used 10–15 ml of LA volume, but did not state the selectiveness of the block with individual nerve assessment, instead collectively noted a difference in sustained hand grip or reported as a failed block. [ 11 12 13 ] One of the authors recently explored the selective C5 nerve root injection with SCN block as a sole anaesthetic technique for clavicle surgery in 20 patients. [ 4 ] Even though the strategy was more site-specific with the sparing of musculocutaneous nerve in 100% of the patients and axillary nerve in 60% patients, there was inadequate blockade in four out of 20 patients (i.e.…”