Key result
Suprascapular with costoclavicular nerve block offered lower analgesia quality compared to interscalene nerve block, with more patients requiring postoperative nalbuphine (76% vs 32%; P=0.004).
Why the study?
Combined suprascapular and costoclavicular nerve blocks could be an ideal hybrid block compared with interscalene nerve block for postoperative analgesia in arthroscopic shoulder surgery.
Does combined suprascapular and costoclavicular nerve block provide non-inferior postoperative analgesia compared to interscalene nerve block in adult patients undergoing arthroscopic shoulder surgery?
RCT (n=50)
1:1 ratio
Does combined suprascapular and costoclavicular nerve block provide non-inferior postoperative analgesia compared to interscalene nerve block in adult patients undergoing arthroscopic shoulder surgery?
Absolute Event Rate: 76% vs 32%
p-value: p=0.004
Combined suprascapular and costoclavicular nerve block offers lower quality analgesia compared to interscalene nerve block in arthroscopic shoulder surgery.
ISB provides superior early analgesia versus DSB after shoulder arthroscopy; challenges DSB as non-inferior and supports ISB preference in future trials.
Background Suprascapular nerve block (SSB) with costoclavicular nerve block (CCB) could be an ideal hybrid block for arthroscopic shoulder surgery in comparison to interscalene nerve block (ISB) regarding postoperative analgesia.Methods Fifty adult patients scheduled to undergo elective arthroscopic shoulder surgery under general anesthesia were equally randomized and enrolled in this study in a 1:1 ratio either to ISB group or diaphragm sparing block DSB (received combined SSB plus CCB blocks). The first numeric pain score (NRS) on awakening was recorded (1), then every 15 minutes over 3 hours. The time to 1st rescue analgesia and the number of patients who required nalbuphine to decrease pain scores below 4/10 were recorded. The incidence of persistent pain after 1 month was recorded as well.Results Pain NRS was significantly lower in ISB than DSB group during the early 3 hours postoperatively (p < 0.001). The time to rescue analgesia was significantly longer in group ISB than group DSB (179.50 ± 40.9 versus 57.38 ± 19.57 min, respectively, with p = 0.013). The number of patients who required postoperative nalbuphine was significantly fewer in group ISB than group DSB (8 versus 19, respectively, with p = 0.004). The incidence of persistent pain after 1 month was insignificant between the two groups.Conclusions SSB with CCB offered lower analgesia quality compared to ISB in shoulder surgery.
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Kamel et al. (2022) conducted an RCT in arthroscopic shoulder surgery (n=50). Suprascapular nerve block with costoclavicular nerve block vs. Interscalene nerve block was evaluated on Requirement for postoperative nalbuphine to decrease pain scores below 4/10 (p=0.004). Suprascapular with costoclavicular nerve block offered lower analgesia quality compared to interscalene nerve block, with more patients requiring postoperative nalbuphine (76% vs 32%; P=0.004).
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