Efficacy of suprascapular nerve block compared with subacromial injection: a randomized controlled trial in patients with rotator cuff tears

被引:23
作者
Coory, Joseph A. [1 ]
Parr, Adam F. [1 ]
Wilkinson, Matthew P. [1 ]
Gupta, Ashish [1 ,2 ]
机构
[1] Townsville Hosp, Douglas, Qld, Australia
[2] Greenslopes Private Hosp, Brisbane, Qld, Australia
关键词
Shoulder; rotator cuff; anesthesia; pain management; suprascapular nerve block; subacromial injection; nonoperative management; CONSTANT SCORE; SUPRASPINATUS; MUSCLE; NEUROPATHY; ANATOMY; BRANCH;
D O I
10.1016/j.jse.2018.11.051
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Hypothesis: We aimed to compare the clinical efficacy of a suprascapular nerve block (SSNB) versus subacromial injection (SA) for outpatient treatment of patients with symptomatic rotator cuff tears in a double-blinded. randomized controlled trial using sealed-envelope randomization. Methods: A total of 42 participants with symptomatic partial- and full-thickness rotator cuff tears quantified by ultrasound or magnetic resonance imaging received either an ultrasound-guided SSNB or SA. The primary outcome measure was shoulder function measured by the modified Constant-Murley (CM) score and the secondary outcome was the pain score measured by a visual analog scale at 2, 6, and 12 weeks after injection. Results: We analyzed 43 shoulders (27 in male patients, 62.2%). The mean age was 65.2 years (standard deviation [SD], 11.9 years). Of the shoulders, 22 (51.2%) underwent SAs and 21 (48.M) underwent SSNBs. Continuous variables were analyzed by an independent r test (2 tailed), and nominal data were analyzed by the Fisher exact test (1 sided). At 6 weeks. the mean change from the baseline CM score was significantly higher in the SSNB group than in the SA group (14.3 [SD, 18.1] vs 3.0 [SD, 12.8]; P = .048). At 12 weeks' follow-up, the SSNB group had a significantly higher CM score than the SA group (57.6 [Si), 101 vs 44.6 [SD, 16]; P= .023) and greater improvement from the baseline CM score (23.4 [SD, 17.5] vs 7.8 [SD, 16.5]; P= .014). At 12 weeks, the visual analog scale score was significantly better in the SSNB group than in the SA cohort (9.9 [SD, 33] vs 7.3 [SD, 4.3]; P= .03). Conclusions: This study demonstrates that an SSNB resulted in better pain and functional results than an SA at 6 and 12 weeks for symptomatic rotator cuff tears. Crown Copyright (C) 2018 All tights reserved.
引用
收藏
页码:430 / 436
页数:7
相关论文
共 36 条
  • [1] AJMANI ML, 1994, J ANAT, V185, P439
  • [2] An anatomic study of the effects on the suprascapular nerve due to retraction of the supraspinatus muscle after a rotator cuff tear
    Albritton, MJ
    Graham, RD
    Richards, RS
    Basamania, CJ
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2003, 12 (05) : 497 - 500
  • [3] A standard method of shoulder strength measurement for the Constant score with a spring balance
    Bankes, MJK
    Crossman, JE
    Emery, RJH
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 1998, 7 (02) : 116 - 121
  • [4] BIGLIANI L U, 1990, Arthroscopy, V6, P301, DOI 10.1016/0749-8063(90)90060-Q
  • [5] Image-guided versus blind glucocorticoid injection for shoulder pain
    Bloom, Jason E.
    Rischin, Adam
    Johnston, Renea V.
    Buchbinder, Rachelle
    [J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2012, (08):
  • [6] Suprascapular neuropathy in a shoulder referral practice
    Boykin, Robert E.
    Friedman, Darren J.
    Zimmer, Zachary R.
    Oaklander, Anne Louise
    Higgins, Laurence D.
    Warner, Jon J. P.
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2011, 20 (06) : 983 - 988
  • [7] Suprascapular Neuropathy
    Boykin, Robert E.
    Friedman, Darren J.
    Higgins, Laurence D.
    Warner, Jon J. P.
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2010, 92A (13) : 2348 - 2364
  • [8] Brown TD, 2000, ORTHOPEDICS, V23, P329
  • [9] Buchbinder R, 2003, Cochrane Database Syst Rev, pCD004016
  • [10] Suprascapular Nerve Block A Narrative Review
    Chan, Chin-wern
    Peng, Philip W. H.
    [J]. REGIONAL ANESTHESIA AND PAIN MEDICINE, 2011, 36 (04) : 358 - 373