Suprascapular Nerve Block Prolongs Analgesia After Nonarthroscopic Shoulder Surgery but Does Not Improve Outcome

Neal, Joseph M.; McDonald, Susan B.; Larkin, Kathleen L.; Polissar, Nayak L.

doi:10.1213/01.ane.0000052380.69541.d4

Cited by 74 publications

(49 citation statements)

References 11 publications

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“…Similarly Neal et al 19 observed mean duration to be 220 min (3.67 h) in SSB group. Ritchie et al, 3 demonstrated that in the immediate post-operative period, a 51% reduction in demand and a 31% reduction in consumption of morphine delivered by a patient-controlled analgesic system in SSB group compared placebo group.…”

Section: Discussionmentioning

confidence: 70%

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

Kumara

Gogia

Bajaj

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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Suprascapular nerve blockInterscalene block Anaesthesia Post-operative analgesia a b s t r a c t Background: Shoulder arthroscopic surgeries have a high incidence of severe post-operative pain significant enough to interfere with recovery and rehabilitation. A regional anaesthetic technique combined with general anaesthesia reduces intra-operative requirements of anaesthesia and provides a better post-operative pain relief. As the commonly employed technique of interscalene brachial plexus block (ISB) is associated with potential serious complications, suprascapular nerve block (SSB) can be used as a safer alternative. Methods and material: In this prospective study, 60 ASA 1 or 2 adult patients undergoing shoulder arthroscopic surgery were randomised into two groups -ISB and SSB. In group ISB, ISB with 20 ml of 0.5% bupivacaine mixed with 75 mg clonidine was given. In the SSB group SSB was given with 15 ml of 0.5% bupivacaine with 75 mg clonidine. Pain was assessed using visual analogue scale and verbal pain scale scores and time to first rescue analgesia was noted. We used Student's t test and Chi-square/Fisher Exact test and used a statistical software to compare data. Results: In the present study, the mean duration of analgesia was 2.53 AE 2.26 h in SSB group compared to 7.23 AE 6.83 h in group ISB ( p value < 0.05). Overall rescue analgesic §

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Section: Discussionmentioning

confidence: 70%

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

Kumara

Gogia

Bajaj

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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“…(1:200,000), 15) 0.25% bupivacaine과 epinephrine 5 mg/ml, 16) 0.25% bupivacaine과 epinephrine (1:200,000), 17) 0.5% bupivacaine, 18) 1% ropivacaine, 19) 0.5% ropivacaine과 epinephrine (1:200,000), 20) 0.5% …”

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confidence: 99%

The Proximal Approach in an Ultrasound-Guided Suprascapular Nerve Block

고¹,

강

신

2017

J Korean Orthop Assoc

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Purpose: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain. Materials and Methods:A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre-and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach.Results: There was significant improvement (p＜0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p＜0.05), and the mean angle of needle entry was 19 degrees in the proximal approach. Conclusion:In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.

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“…Control the pain is one of the main problems in those surgeries, since these procedures are associated with postoperative pain of great intensity and hard to be controlled 8,9 . Among the techniques more commonly employed for this purpose are the use of intravenous opioids associated or not with NSAIDs, the use of articular local anesthetic, suprascapular nerve block and cervical and brachial plexus blocks [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] . Among such techniques, brachial plexus block offers the best results on the analgesia 1,[3][4][5][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

Morais¹,

Cruvinel²,

Carneiro³

et al. 2012

Rev. Bras. Anestesiol.

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18 anos, estado físico ASA I e II, escalados para cirurgias artroscópicas de ombro unilateral foram alocados aleatoriamente em três grupos: A (10 mL a 0,5%), B (20 mL a 0,5%), C (5 mL a 1%). O bloqueio foi realizado com agulha 22G de 100 mm conectada ao neuroestimulador, em um ponto 3 cm lateral ao ponto médio do interespaço de C6 e C7, sendo injetada a solução correspondente a cada grupo. A dor pós-operatória foi avaliada na SRPA e nas primeiras 24 horas do pós-operatório. Os grupos foram comparados quanto ao tempo para primeira queixa de dor, à pontuação na ENV e ao consumo de morfina nas primeiras 24 horas. RESULTADOS: Não houve diferença estatisticamente significativa entre os três grupos em relação a idade, peso e altura. Não houve diferença no tempo até a primeira queixa de dor, ENV superior a três e consumo de morfina no pós-operatório entre os grupos. CONCLUSÕES: O presente estudo concluiu que 5 mL de ropivacaína 1% promoveu eficácia analgésica similar a 10 mL ou 20 mL de ropivacaína 0,5% no bloqueio do plexo braquial pela via posterior com o uso do neuroestimulador]]>

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Suprascapular Nerve Block Prolongs Analgesia After Nonarthroscopic Shoulder Surgery but Does Not Improve Outcome

Abstract: When used as an adjunct to an interscalene block combined with general anesthesia, suprascapular nerve block with bupivacaine moderately prolongs analgesia without improving other outcome measures after ambulatory nonarthroscopic shoulder surgery.

Cited by 74 publications

References 11 publications

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

The Proximal Approach in an Ultrasound-Guided Suprascapular Nerve Block

Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

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