Ultrasound-guided Suprascapular Nerve Block

The suprascapular nerve is a mixed motor and sensory peripheral nerve arising from the superior trunk of the brachial plexus. The nerve supplies motor innervation to shoulder muscles and sends sensory branches to multiple places in the shoulder region. Ultrasound-guided suprascapular nerve block (SSNB) is a safe and effective method to treat acute and chronic pain in diseases that affect the shoulder.

The healthy shoulder joint allows us to move our arms a full 270 degrees in range, which no other joint can do. When we consider the shoulder’s range of motion and its complexity, it’s no wonder that this joint is particularly prone to injuries.

When the pain in these injuries doesn’t resolve with painkillers and anti inflammation drugs, an injection of long acting steroid and local anesthetic into the suprascapular notch in proximity to the nerve will reduce pain and allow more comfortable movement. This regained range of motion helps the patient to do more intense rehabilitation.

Sometimes Surgical treatment is considered after a concerted effort at conservative management has failed. Shoulder surgery may cause considerable pain in the first 24 hours after the operation and yo a less extent in the following weeks. One of the most common methods of relieving this pain is to use a procedure called Interscalene Brachial Plexus Block. This is a technique that is sometimes employed as an alternative or as an adjunct to general anesthesia for surgery of the upper extremity. This technique involves the injection of local anesthetic agents in close proximity to the brachial plexus, temporarily blocking the sensation and ability to move the upper extremity.

While this procedure is a potent option to control pain after shoulder surgery, it has notable adverse effects i.e. reduced grip strength. Ultrasound-guided anterior suprascapular nerve block (SSNB) has proven to provide comparable analgesia and cause less grip-strength impairment. These characteristics were studied in a randomized controlled patient and assessor-blinded trial at the Department of Anesthesiology, ACQUA Clinic, Leipzig, Germany.

Ultrasound does not expose patients and personnel to radiation. It is also less expensive than other imaging modalities. We highly recommend the Linear 5-12MHz Ultrasound Scanner SIFULTRAS-9.53 for this procedure. It has a wide range of frequency from 5 to 12MHz and a scanning mode of  B,B+B,B+m with high resolution imaging (128 elements) that makes it very suitable for this specific task..

This procedure is done by an orthopedic surgeon.

Reference: Ultrasound-guided Suprascapular Nerve Block Technique
Anterior Suprascapular Nerve Block Versus Interscalene Brachial Plexus Block for Shoulder Surgery in the Outpatient Setting: A Randomized Controlled Patient- and Assessor-Blinded Trial

 

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