2019 ISAKOS Biennial Congress ePoster #1802
Suprascapular Nerve Blockade for Postoperative Pain Control Following Arthroscopic Shoulder Surgery: A Systematic Review and Meta-Analysis
Jeffrey Kay, MD, Toronto, ON CANADA
Muzammil Memon, MD, Hamilton, ON CANADA
Thomas Hu, Hamilton, ON CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
Andrew Duong, MSc, Hamilton, ON CANADA
George Athwal, MD, Hamilton, ON CANADA
James Paul, MD, Hamilton, ON CANADA
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA
McMaster University, Hamilton, ON, CANADA
FDA Status Not Applicable
Although not as efficacious as the interscalene brachial plexus block Iin terms of pain control, the use of suprascapular nerve block provides patients undergoing shoulder arthroscopy with significantly improved pain control in comparison to patients receiving analgesia without a nerve block.
This systematic review and meta-analysis examines the efficacy of the suprascapular nerve block (SSNB) for pain control following shoulder arthroscopy in comparison to an interscalene brachial plexus block (ISB) as well as anesthesia without a nerve block.
PubMed, MEDLINE, and EMBASE were systematically searched for literature on randomized-controlled trials evaluating SSNB use for pain control following shoulder arthroscopy. A meta-analysis of standard mean differences (SMD) was performed to pool the estimated effects of the nerve blocks.
Overall, 10 RCTs were identified that included 923 patients, with a mean (standard deviation) age of 54 (13) years. The mean follow-up time was 4 days (range, 24 hours - 6 weeks). Postoperative pain was significantly superior in the SSNB groups compared to control groups within 1 hour (SMD, -1.1; 95% confidence interval [CI], -2.0 to -0.1; P = 0.03), 4-6 hours (SMD, -1.1; 95% CI, -1.7 to -0.4; P = 0.002), and 24 hours (SMD, -0.5; 95% CI, -0.8 to -0.1; P = 0.02) postoperatively. No major complications were noted in the SSNB groups across the included studies. Minor complications such as hoarseness and prolonged motor block were significantly less common in SSNB compared to patients with ISB.
Although not as efficacious as the ISB in terms of pain control, the use of SSNB provides patients undergoing shoulder arthroscopy with significantly improved pain control in comparison to patients receiving analgesia without a nerve block. Moreover, the SSNB is a safe procedure with few major and minor complications reported.