Suprascapular Nerve Block Associated With Subacromial Anesthetic Infusion in Arthroscopic Rotator Cuff Repair

Abstract

Abstract The purpose of this article is to describe the technique and evaluate the intraoperative and postoperative efficacy of suprascapular nerve block associated with anesthetic infusion into the subacromial space, and compare it with the efficacy of the interscalene block method. Forty-five patients with small or medium isolated lesions of the supraspinatus tendon who underwent arthroscopic repair were prospectively evaluated. Participants were assigned to 3 groups (A, B, and C) of 15 by using restricted randomization by minimization. Group A underwent arthroscopic rotator cuff repair under general anesthesia with interscalene nerve block without using the nerve stimulator device, whereas group B received general anesthesia associated with suprascapular nerve block and anesthetic infusion into the subacromial space before surgery; group C underwent suprascapular nerve block and anesthetic infusion into the subacromial space after surgery. Inhalation anesthetic consumption during surgery was compared among the 3 groups. The postoperative analgesic efficacy of each anesthetic method was measured using the visual analog scale, as well as observing the analgesic drugs consumption. The statistical analysis found no significant differences among patients in the 3 groups in terms of anesthetic consumption during surgery, postoperative analgesic efficacy during the first 48 hours and analgesic drug consumption. The 3 techniques provided similar results in terms of efficacy concerning pain control, anesthetic consumption, analgesic, and antiinflammatory drug consumption, showing that suprascapular nerve block technique with anesthetic infusion into the subacromial space is an excellent alternative to interscalene block, particularly in hospitals where the nerve stimulator device is unavailable.