Skip to main content
SpringerLink
Log in

Suprascapular nerve block as a method of preemptive pain control in shoulder surgery

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of the study was to evaluate the effect of suprascapular nerve block (SSNB) in shoulder surgery. The study group consisted of 260 patients, which were subjected to shoulder operations. The patients were divided into two equal groups: group I with nerve block compared to a control group II without a nerve block. The mean age of the patients in group I was 56.2 ± 6.86 years and that in group II was 54.5 ± 7.06 years. The female to male ratio was 71:59 in group I and was 69:61 in group II. Surgical procedures were arthroscopic rotator cuff repair, arthroscopic subacromial decompression, arthroscopic acromioclavicular resection, arthroscopic removal of calcific tendonitis, arthroscopic reconstruction of instability, arthroscopic capsular release and shoulder replacement. In all cases the pain was documented by the visual analogue scale (VAS) preoperative, at the first, the second as well as at the third day after surgery. In order to evaluate the amount of fluid, which is needed for infiltration of the area of the supraspinatus fossa, we injected different amount of local anesthetic in combination with contrast dye in five patients. In this study to document the fluid distribution, after injecting with different milliliters, 10 ml is proved to be more than enough to have sufficient local anesthetic to block the SSN. Pre-operatively the mean VAS was comparable between both groups. We documented a significant difference in favour of SSNB from day 1 to day 3 after surgery. No specific complications due to this nerve block procedure were found in any patient post-operatively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Alam S (1996) Suprascapular nerve block. Reg Anesth 21:371–373

    PubMed  CAS  Google Scholar 

  2. Al-Kaisy A, McGuire G, Chan VW et al (1998) Analgesic effect of interscalene block using low-dose bupivacaine for outpatient tarthroscopic shoulder surgery. Reg Anesth Pain Med 23:469–473

    Article  PubMed  CAS  Google Scholar 

  3. Arciero RA, Taylor DC, Harrison SA, Snyder RJ, Leahy KE, Uhorchak JM (1996) Interscalene anesthesia for shoulder arthroscopy in a community-sized military hospital. Arthroscopy 12:715–719

    PubMed  CAS  Google Scholar 

  4. Barber FA, McGuire DA, Click S (1998) Continuous flow cold therapy for outpatient ACL reconstruction. Arthroscopy 14:130–135

    PubMed  CAS  Google Scholar 

  5. Barber FA, Herbert MA (2002) The effectiveness of an anesthetic continuous-infusion device on postoperative pain control. Arthroscopy 18:76–81

    PubMed  Google Scholar 

  6. Boden BP, Fassler S, Cooper S, Marchetto PA, Moyer RA (1994) Analgesic effect of intra-articular morphine, bupivacaine, and morphine/bupivacaine after arthroscopic knee surgery. Arthroscopy 10:104–107

    PubMed  CAS  Google Scholar 

  7. Brown AR, Weiss R, Greenberg C, Flatow EL, Bigliani LU (1993) Interscalene block for shoulder arthroscopy: comparison with general anesthesia. Arthroscopy 9:295–300

    PubMed  CAS  Google Scholar 

  8. Coetzee GJ, de Beer JF, Pritchard MG, van Rooyen K (2004) Suprascapular nerve block: An alternative method of placing a catheter for continuous nerve block. Reg Anesth Pain Med 29:75–76

    Article  PubMed  Google Scholar 

  9. Dahan TH, Fortin L, Pelletier M, Petit M, Vadeboncoeur R, Suissa S (2000) Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol 27:1464–1469

    PubMed  CAS  Google Scholar 

  10. Di Lorenzo L, Pappagallo M, Gimigliano R, Palmieri E, Bello A, Forte A, DeBlasio E, Trombetti C (2006) Pain relief in early rehabilitation of rotator cuff tendinitis: any role for indirect suprascapular nerve block? Eura Medicophys 42(3):195–204

    PubMed  CAS  Google Scholar 

  11. Fournier R, Haller G, Hoffmeyer P, Gamulin Z (2001) Suprascapular nerve block by a new anterior approach for perioperative analgesia during major scapular surgery in two patients. Reg Anesth Pain Med 26:288–289

    Article  PubMed  CAS  Google Scholar 

  12. Karatas GK, Meray J (2002) Suprascapular nerve block for painrelief in adhesive capsulitis: comparison of 2 different techniques. Arch Phys Med Rehabil 83:593–597

    Article  PubMed  Google Scholar 

  13. Lewis RN (1999) The use of combined suprascapular and circumflex (articular branches) nerve blocks in the management of chronic arthritis of the shoulder joint. Eur J Anaesthesiol 16:37–41

    Article  PubMed  CAS  Google Scholar 

  14. Mercadante S, Sapio M, Villari P (1995) Suprascapular nerve block by catheter for breakthrough shoulder cancer pain. Reg Anesth 20:343–346

    PubMed  CAS  Google Scholar 

  15. Meyer-Witting M, Foster JM (1992) Suprascapular nerve block in the management of cancer pain. Anaesthesia 47:626

    Article  PubMed  CAS  Google Scholar 

  16. Neal JM, McDonald SB, Larkin KL, Polissar NL (2003) Suprascapular nerve block prolongs analgesia after nonarthroscopic shoulder surgery but does not improve outcome. Anesth Analg 96:982–986

    Article  PubMed  Google Scholar 

  17. Neviaser TJ (1987) Arthroscopy of the shoulder. Orthop Clin North Am 18:361–372

    PubMed  CAS  Google Scholar 

  18. Nord KD, Mauck BM (2003) The new subclavian portal and modified Neviaser portal for arthroscopic rotator cuff repair. Arthroscopy 19:1030–1034

    PubMed  Google Scholar 

  19. Richardson MD, Bjorksten AR, Hart JA, McCullough K (1997) The efficacy of intra-articular morphine for postoperative knee arthroscopy analgesia. Arthroscopy 13:584–589

    Article  PubMed  CAS  Google Scholar 

  20. Ritchie ED, Tong D, Chung F, Norris AM, Miniaci A, Vairavanathan SD (1997) Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality? Anesth Analg 84(1):1306–1312

    Article  PubMed  CAS  Google Scholar 

  21. Savoie FH, Field LD, Jenkins RN, Mallon WJ, Phelps RA 2nd (2000) The pain control infusion pump for postoperative pain control in shoulder surgery. Arthroscopy 16:339–342

    PubMed  CAS  Google Scholar 

  22. Shanahan EM, Ahern M, Smith M, Wetherall M, Bresnihan B, FitzGerald O (2003) Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain. Ann Rheum Dis 62:400–406

    Article  PubMed  CAS  Google Scholar 

  23. Shanahan EM, Smith M, Wetherall M, Lott CW, Slavotinek J, Fitzgerald O, Ahern MJ (2004) Suprascapular nerve block in chronickshoulder pain: are the radiologists better? Ann Rheum Dis 63(9):1035–1040

    Article  PubMed  CAS  Google Scholar 

  24. Speer KP, Warren RF, Horowitz L (1996) The efficacy of cryotherapy in the postoperative shoulder. J Shoulder Elbow Surg 5:62–68

    Article  PubMed  CAS  Google Scholar 

  25. Taskaynatan MA, Yilmaz B, Ozgul A, Yazicioglu K, Kalyon TA (2005) Suprascapular nerve block versus steroid injection for non-specific shoulder pain. Tohoku J Exp Med 205(1):19–25

    Article  PubMed  Google Scholar 

  26. Uysalel A, Kecik Y, Kirdemir P, Sayin M, Binnet M (1995) Comparison of intra-articular bupivacaine with the addition of morphine or fentanyl for analgesia after arthroscopic surgery. Arthroscopy 11:660–663

    PubMed  CAS  Google Scholar 

  27. Wurm WH, Concepcion M, Sternlicht A et al (2003) Preoperative interscalene block for elective shoulder surgery: loss of benefit over early postoperative block after patient discharge to home. Anesth Analg 97:1620–1626

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department for Orthopedic Surgery, Johanna-Etienne Hospital, Am Hasenberg 46, 41462, Neuss, Germany

    J. Jerosch, M. Saad & M. Greig

  2. Anatomic Department, University Muenster, Muenster, Germany

    T. Filler

Authors
  1. J. Jerosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Saad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Greig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Filler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Jerosch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jerosch, J., Saad, M., Greig, M. et al. Suprascapular nerve block as a method of preemptive pain control in shoulder surgery. Knee Surg Sports Traumatol Arthr 16, 602–607 (2008). https://doi.org/10.1007/s00167-008-0520-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-008-0520-3

Keywords

Search

Navigation