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KMID : 0361620170520060521
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Journal of the Korean Orthopaedic Association
2017 Volume.52 No. 6 p.521 ~ p.528
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The Proximal Approach in an Ultrasound-Guided Suprascapular Nerve Block
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Ko Kwang-Pyo
Kang Dong-Hun
Shin Byung-Kon
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Abstract
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Purpose: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain.
Materials and Methods: A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre- and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach.
Results: There was significant improvement (p<0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p<0.05), and the mean angle of needle entry was 19 degrees in the proximal approach.
Conclusion: In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.
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KEYWORD
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shoulder, ultrasound, suprascapular nerve block, proximal approach, omohyoid muscle
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