“Ultrasound-guided suprascapular nerve block combined with intra-articular injection of bupivacaine versus ultrasound-guided interscalene nerve block in shoulder arthroscopy”

Hussein, Mostafa M; Abdellatif, Ayman A; Shahrour, Mohamed T; Wareth, Mohamed A

doi:10.21608/asmj.2024.263361.1208

“Ultrasound-guided suprascapular nerve block combined with intra-articular injection of bupivacaine versus ultrasound-guided interscalene nerve block in shoulder arthroscopy”

Document Type : Original Article

Authors

¹ Associate Professor, Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Professor, Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

³ Assistant Lecturer, Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

⁴ Lecturer, Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/asmj.2024.263361.1208

Abstract

Background: The interscalene nerve block (ISNB) is widely recognized as the most optimal technique for effectively managing postoperative pain following shoulder surgery. Nevertheless, this technique is linked to adverse effects and potential complications. The current work sought to compare the efficacy of ISNB with a selective suprascapular nerve block and intra-articular injections of bupivacaine (SSNB + IAI) for postoperative analgesia following shoulder arthroscopy guided by ultrasonography (US). Methods: This study included thirty patients (aged 21-60 years) who were slated to undergo elective shoulder arthroscopy under general anesthesia. They were categorized into two groups: Group A underwent ultrasound-guided ISNB after general anesthesia (GA), and Group B received ultrasound-guided SSNB + IAI after GA induction. The postoperative pain was estimated utilizing the visual analog scale (VAS) as a main measure. Secondary outcomes included total pethidine dose administered within 24 hours after surgery, patient satisfaction, and other complications. Results: The VAS scores at various time points after the surgery showed non-significant changes among the ISNB and SSNB groups, except at VAS 0 hours postoperatively, where a notable distinction was observed; however, the VAS score remained below 3; therefore, no analgesics were administered. Surprisingly, the expression of postoperative pain reportedly improved. This might be because ISNB offers a particularly dense block compared to SSNB.
Conclusion: Ultrasound-guided SSNB, when used with IAI, was nearly as effective in providing postoperative analgesia following shoulder arthroscopy while offering lower potential side effects.

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