Sultan J, Wilson J, Glover J, Goodyear E, Narendran U, Roy B.Trafford General Hospital Ultrasound-Guided Suprascapular Nerve Block for Patients with Persistent Shoulder Pain
Introduction • 70% of pain sensation around the shoulder is transmitted via the suprascapular nerve • Suprascapular nerve block (SSNB) has been previously described as a method of controlling pain from the shoulder (rheumatology clinics) • Bedside ultrasound-guided nerve blocks
Aim • To assess the efficacy of ultrasound-guided suprascapular nerve block for pain control in a group of patients with persistent shoulder pain and reduced function.
Methods • Two experienced anaesthetists; • High-resolution ultrasound scanner, • Nerve was visualised in the suprascapular notch, • 10-15 mLs of 0.5% Bupivacaine
Methods • Jan 2010 – Sep 2010 • 24 consecutive patients • Inclusion criteria:- Primary frozen shoulder - Persistent postoperative stiffness failed physiotherapy and oral analgesia • Three patients were excluded:- 2 were lost to follow-up- 1 underwent surgery within 2 weeks
Methods • Numerical analogue pain score (NAPS, 0-10) at:Pre-block, 20min, 2-3 days, 2 weeks and 8 weeks • Oxford Shoulder Score (OSS) at pre-block and 8 weeks post-block. • Complications
Results • 11 (55%) females • 12 right, 9 left • Mean age 55 ± 11 years • 9 post-operative stiffness8 primary frozen shoulders2 others
Results • 19 (90%) patients had significant improvement of their NAPS and OSS,2 (10%) had no significant improvement • Mean post-block NAPS were significantly lower than pre-block NAPS at all points (p<0.0001) • Mean OSS was significantly improved at 8 weeks (p=0.0005)
Results • No complications recorded • Better response in the persistent postoperative stiffness group (not statistically significant)
Conclusion • SSNB is a simple, quick and safe technique that can achieve rapid, albeit temporary, relief of shoulder pain • Allows time for contemplating other interventions (physiotherapy, surgery) • Further research - compare to other types of injections • Questions?