Ultrasound Guided Interscalene Block & Shoulder Block for Postoperative Analgesia for Shoulder Surgeries

ABSTRACT

Shoulder arthroscopic surgeries can produce intense postoperative pain. Interscalene block provides good analgesia after shoulder surgery, but concerns over its associated risks have prompted the search for alternatives. Suprascapular block along with axillary nerve block was recently proposed as an alternative to interscalene block, but evidence of its comparative efficacy is conflicting. The aim of our study was to compare suprascapular and axillary nerve blocks with interscalene block in shoulder surgery for postoperative analgesia. Methods: A total of 76 patients scheduled for shoulder arthroscopic surgery were equally divided into two groups of 38patients each Interscalene (ISB) group and suprascapular with axillary nerve (SHB) group. Both the nerve block was achieved by both ultrasound and nerve stimulator guidance. Visual analogue scale score was evaluated at 1, 4, 6, 12, and 24 h postoperatively. The time to first analgesia request, total analgesic requirement for 24 hr postoperatively, patient satisfaction, and any complications were recorded. Results: SHB provided equivalent analgesia to ISB in terms of post operative VAS scores.Time to 1st analgesia request was 7.2±1.3 hr in ISB group and 5.9±1.2 hr in SHB group which was not statistically significant.Patient satisfaction scores were significantly higher in SHB group compared to ISB group. Complication like subjective dyspnea and weakness of arm was significantly higher in ISB group compared to SHB group. Conclusions: SHB was as effective as ISB for postoperative pain relief but with fewer complications due to selective blockade of suprascapular and axillary nerve.