ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Suprascapular Nerve Block Provides Adequate Analgesia Following Shoulder Arthroscopy

Michael Warren, MD, New Orleans, LA UNITED STATES
Brian M Godshaw, MD, Metairie, LA UNITED STATES
Michael Nammour, MD, New Orleans, LA UNITED STATES
Misty Suri, MD, New Orleans, LA UNITED STATES

Ochsner Clinic Foundation, New Orleans, Louisiana, UNITED STATES

FDA Status Not Applicable

Summary

Suprascapular block with intraarticular block provides non-inferior clinical analgesia for arthroscopic shouder surgery when compared to interscalene block and suprascapular block alone.

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Abstract

Background

Regional nerve blocks are commonly used to manage pain after arthroscopic shoulder surgery. Interscalene block has commonly been used, however increasing reported side effects and high cost has prompted the search for alternatives. Intraoperative suprascapular nerve block plus intraarticular local anesthetic block is an emerging treatment method to decrease postoperative pain and subsequent opioid use.

Purpose

To compare the efficacy of interscalene block (ISB), suprascapular block (SSB) and suprascapular block with intraarticular block (SSIA) for postoperative analgesia after arthroscopic shoulder surgery.

Methods

The study enrolled patients undergoing arthroscopic shoulder surgery. This single site, single surgeon study was performed on consecutive patients in 2018-2019. To be included patients must have undergone arthroscopic shoulder surgery, received either ISB, SSB, SSIA, and have had adequately documented pain ratings and medications administered in the immediate post-operative period. The primary outcomes were patient’s pain level, as measured by the visual analogue scale (VAS), and morphine-equivalents (MEQ) received during their stay in PACU.

Results

A total of 245 patients met inclusion criteria with 81 patients receiving ISB, 83 patients receiving SSB, and 81 patients receiving SSIA. Interscalene block resulted in the lowest mean pain of 4.82. When comparing ISB group to SSB group, the ISB group had lower pain 4.82 vs. 5.58 however this did not meet minimum clinical important difference (MCID). Pain was also lower in ISB group when compared the SSIA group (4.82 vs. 5.41) however this also did not meet MCID. There was no difference in morphine equivalents consumed between any of the groups.

Conclusion

Suprascapular block with intraarticular block provides non-inferior clinical analgesia when compared to interscalene block and suprascapular block alone. There was no difference in morphine equivalents in any of the study groups. Suprascapular block with intraarticular analgesia provides effective analgesia for shoulder arthroscopy with less risk of adverse events than an interscalene block.

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