ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2019 April;85(4):344-50

DOI: 10.23736/S0375-9393.18.12791-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Interscalenic versus suprascapular nerve block: can the type of block influence short- and long-term outcomes? An observational study

Michele DIVELLA ¹ ✉, Luigi VETRUGNO ¹, Daniele ORSO ¹, Nicola LANGIANO ¹, Elena BIGNAMI ², Tiziana BOVE ¹, Giorgio DELLA ROCCA ¹

¹ Department of Medicine, Clinic of Anesthesiology and Intensive Care, University of Udine, Udine, Italy; ² Division of Anesthesiology, Critical Care and Pain Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy

BACKGROUND: While interscalenic nerve block (INB) is still considered the gold standard for shoulder arthroscopy, its postoperative analgesic effectiveness has recently been called into question. Meanwhile, in light of its high-quality postoperative pain relief, a renewed interest has emerged in suprascapular nerve block (SNB). The first aim of our study was to compare the postoperative analgesia effects of these two types of block at two, four and six hours after surgery. We also assessed shoulder functional recovery over a 6-month follow-up period.
METHODS: All patients requiring arthroscopic shoulder surgery for rotator cuff repair during the study period were enrolled. INB or SNB was performed under ultrasound guidance. The patients underwent general anaesthesia. Numerical rate scores (NRS) at rest and in motion at two, four and six postoperative hours were recorded.
RESULTS: Over two years, 280 patients were screened. Of these, 136 were excluded. Pain scores after surgery were lower at two hours in INB at rest (0.70±1.50 versus 2.1±2.2; P<0.0067) and after movement (1.0±2.2 versus 2.5±2.3; P=0.01). A significant difference in terms of arm extrarotation degrees at week 6 and month 2 (P<0.01) in SNB was found.
CONCLUSIONS: INB showed better analgesic efficacy in the immediate postoperative period. Both types of block showed similar results in terms of functional recovery over the six-month follow-up. SNB without motor block seems matched better with ambulatory surgery and with an early rehabilitation program.

KEY WORDS: Ultrasonography; Nerve block; Anesthesia; Shoulder; Arthroscopy; Pain, postoperative