Basic ScienceDistal suprascapular nerve block—do it yourself: cadaveric feasibility study
Section snippets
Materials and methods
Fifteen shoulders from 8 fresh frozen cadavers were included. The median age of the specimens (2 men, 6 women) was 82 years (74-98 years) with a median body mass index (BMI) of 24 kg/m2 (range, 18.8-30.1 kg/m2). A history of irradiation to the brachial plexus or shoulder surgery and trauma in the cervical, scapular, supraclavicular, or shoulder girdle area were exclusion criteria. None of the specimens were excluded.
Accuracy of the dSSN block
The median distance between the dSSN at the suprascapular notch and the site of injection was 1.5 cm (range, 0-4.5 cm). The needle tip was distal to the suprascapular notch in all 15 cadaver shoulders (100%); the most common injection site was at the proximal third of the neck of the scapula (n = 8 [53%]) (Fig. 2). Cadaver BMI (coefficient (ß), 0.625; 95% confidence interval, −1.42 to 2.67; P = .516) had no impact on accuracy (ie, distance of the needle’s tip to the dSSN at the suprascapular
Discussion
This study confirmed the primary and secondary hypotheses. LBAs performed by an orthopedic surgeon allowed reliable and accurate marking of 100% of the dSSNs and their sensory branches.
Implementation of this technique as one branch in a multimodal approach to the treatment of perioperative, chronic, and recalcitrant shoulder pain has the potential to significantly reduce the use of narcotic pain medication.4, 6, 12, 22, 26, 27, 33 Anesthetic block of the dSSN is widely used by clinical
Conclusion
Data herein suggest that the LBA for anesthetic blockade of the dSSN by an orthopedic surgeon is a simple, reliable, and accurate method. We recommend injecting close to the suprascapular notch to involve the dSSN proximally as well as the 3 sensory branches, ensuring analgesia about the coracoclavicular ligaments, the subacromial bursa, and the PGH joint capsule. Further studies are needed to determine the safety and analgesic effectiveness of this method when it is performed by an orthopedic
Acknowledgments
The authors would like to thank the persons who donated their bodies to the department of Applied Anatomy (Faculty of Medicine, Toulouse, France; and Faculty of Medicine, Reims, France), without which this study would not have been possible.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (0)
Institutional Review Board approval was not required for this study.