A COMPARATIVE STUDY BETWEEN INTERSCALENE BLOCK AND SUPRASCAPULAR PLUS AXILLARY NERVE BLOCK IN PATIENTS UNDERGOING SHOULDER SURGERY

Abstract

The interscalene block is the gold standard for shoulder anesthesia. The suprascapular nerve block combined with an axillary nerve block may provide an efcacious alternative to the interscalene nerve block for shoulder surgery. To compare interscalene block with suprascapular plus axillary nerve block for shoulder surgery in terms of quality of anaesthesia, duration of analgesia and, associated complications. Seventy one patients were randomly allocated in two groups to receive either interscalene block (Group IG, number of patients =35) or suprascapular plus axillary nerve block (Group SG, number of patients = 36). Onset of block, quality of block, failure rate and incidence of complications were observed. Postoperative pain was assessed by Visual Analog Scale. Score ≥4 was considered as signicant pain and, rescue analgesic injection tramadol 100 mg was administered. Onset of sensory block was 17.67±6.11 min and 15.29±1.72 min in group SG and IG respectively. Similarly duration of block was 247.61±78.46 min (Group SG) and 268.11±24.78 min (Group IG) (p=0.1332). Majority of patients had grade III motor block in group IG (74%) and grade II in group SG (89%). Three patients had either partial or complete failure of block in SG group. Interscalene block provided longer duration of postoperative analgesia. Both interscalene block and suprascapular plus axillary nerve block provide effective anaesthesia and analgesia for shoulder surgery. Although quality of block is better following interscalene block; suprascapular and axillary nerve blocks are associated with fewer side effects.