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Efficacy and safety of suprascapular nerve block combined with axillary nerve block for arthroscopic shoulder surgery: A systematic review and meta-analysis of randomized controlled trials.
Int J Surg. 2021 Oct; 94:106111.IJ

Abstract

BACKGROUND AND AIMS

A variety of peripheral nerve block methods are used in the clinic to enhance the effect of postoperative analgesia. In recent years, an increasing number of surgeons have considered the efficacy and safety of suprascapular nerve block (SSNB) combined with axillary nerve block (ANB) for controlling perioperative pain in shoulder arthroscopy. The purpose of this study was to compare the efficacy and safety of SSNB + ANB and interscalene block (ISB) versus SSNB alone for shoulder arthroscopic surgery.

STUDY DESIGN

Systematic review; Level of evidence, 1.

METHODS

The protocol for this meta-analysis is registered with PROSPERO (CRD42021254008). PubMed, Cochrane Library, Embase and CNKI were searched for RCTs from inception to April 30, 2021. A meta-analysis was performed with Review Manager 5.3 to calculate the RR or WMD of related outcome indicators.

RESULTS

Nine RCTs involving 543 cases from 5 countries were included. Compared with SSNB alone, SSNB + ANB was more effective at pain relief at 6, 12, 24, 36 and 48 h postoperatively. In terms of patient satisfaction score, scores for SSNB + ANB at 12 (WMD = 2.01, 95% CI = 0.25 to 3.78) and 24 (WMD = 1.68, 95% CI = 0.11 to 3.24) hours after the operation were higher than those of SSNB alone, but there was no significant difference at 36 and 48 h postsurgery. There was no significant difference in pain score between SSNB + ANB and ISB at 6 and 12 h after surgery or in patient satisfaction at 24 h (WMD = 0.13, 95% CI = -0.36 to 0.63) postsurgery between SSNB + ANB and ISB. In terms of safety, compared with ISB, SSNB + ANB reduced the incidence of dyspnea (RR = 0.25, 95% CI = 0.09 to 0.68).

CONCLUSIONS

Compared with SSNB alone, SSNB + ANB has better advantages regarding pain relief and patient satisfaction within 24 h after surgery. Compared with ISB, SSNB + ANB shows no difference in postoperative pain relief or patient satisfaction, but SSNB + ANB can reduce the incidence of dyspnea more than ISB.

Authors+Show Affiliations

The Research Team on Bone and Joint Degeneration and Injury of Guangdong Academy of Traditional Chinese Medicine, Guangzhou, 510120, China The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guagnzhou, 510405, China Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, 510095, China The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China The Department of Sports Medicine of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, 510120, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34520842

Citation

Zhao, Jinlong, et al. "Efficacy and Safety of Suprascapular Nerve Block Combined With Axillary Nerve Block for Arthroscopic Shoulder Surgery: a Systematic Review and Meta-analysis of Randomized Controlled Trials." International Journal of Surgery (London, England), vol. 94, 2021, p. 106111.
Zhao J, Xu N, Li J, et al. Efficacy and safety of suprascapular nerve block combined with axillary nerve block for arthroscopic shoulder surgery: A systematic review and meta-analysis of randomized controlled trials. Int J Surg. 2021;94:106111.
Zhao, J., Xu, N., Li, J., Liang, G., Zeng, L., Luo, M., Pan, J., Yang, W., & Liu, J. (2021). Efficacy and safety of suprascapular nerve block combined with axillary nerve block for arthroscopic shoulder surgery: A systematic review and meta-analysis of randomized controlled trials. International Journal of Surgery (London, England), 94, 106111. https://doi.org/10.1016/j.ijsu.2021.106111
Zhao J, et al. Efficacy and Safety of Suprascapular Nerve Block Combined With Axillary Nerve Block for Arthroscopic Shoulder Surgery: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Surg. 2021;94:106111. PubMed PMID: 34520842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of suprascapular nerve block combined with axillary nerve block for arthroscopic shoulder surgery: A systematic review and meta-analysis of randomized controlled trials. AU - Zhao,Jinlong, AU - Xu,Nanjun, AU - Li,Jiahui, AU - Liang,Guihong, AU - Zeng,Lingfeng, AU - Luo,Minghui, AU - Pan,Jianke, AU - Yang,Weiyi, AU - Liu,Jun, Y1 - 2021/09/11/ PY - 2021/07/14/received PY - 2021/08/20/revised PY - 2021/09/10/accepted PY - 2021/9/15/pubmed PY - 2021/11/12/medline PY - 2021/9/14/entrez KW - Arthroscopic shoulder surgery KW - Axillary nerve block KW - Interscalene block KW - Meta-analysis KW - Suprascapular nerve block SP - 106111 EP - 106111 JF - International journal of surgery (London, England) JO - Int J Surg VL - 94 N2 - BACKGROUND AND AIMS: A variety of peripheral nerve block methods are used in the clinic to enhance the effect of postoperative analgesia. In recent years, an increasing number of surgeons have considered the efficacy and safety of suprascapular nerve block (SSNB) combined with axillary nerve block (ANB) for controlling perioperative pain in shoulder arthroscopy. The purpose of this study was to compare the efficacy and safety of SSNB + ANB and interscalene block (ISB) versus SSNB alone for shoulder arthroscopic surgery. STUDY DESIGN: Systematic review; Level of evidence, 1. METHODS: The protocol for this meta-analysis is registered with PROSPERO (CRD42021254008). PubMed, Cochrane Library, Embase and CNKI were searched for RCTs from inception to April 30, 2021. A meta-analysis was performed with Review Manager 5.3 to calculate the RR or WMD of related outcome indicators. RESULTS: Nine RCTs involving 543 cases from 5 countries were included. Compared with SSNB alone, SSNB + ANB was more effective at pain relief at 6, 12, 24, 36 and 48 h postoperatively. In terms of patient satisfaction score, scores for SSNB + ANB at 12 (WMD = 2.01, 95% CI = 0.25 to 3.78) and 24 (WMD = 1.68, 95% CI = 0.11 to 3.24) hours after the operation were higher than those of SSNB alone, but there was no significant difference at 36 and 48 h postsurgery. There was no significant difference in pain score between SSNB + ANB and ISB at 6 and 12 h after surgery or in patient satisfaction at 24 h (WMD = 0.13, 95% CI = -0.36 to 0.63) postsurgery between SSNB + ANB and ISB. In terms of safety, compared with ISB, SSNB + ANB reduced the incidence of dyspnea (RR = 0.25, 95% CI = 0.09 to 0.68). CONCLUSIONS: Compared with SSNB alone, SSNB + ANB has better advantages regarding pain relief and patient satisfaction within 24 h after surgery. Compared with ISB, SSNB + ANB shows no difference in postoperative pain relief or patient satisfaction, but SSNB + ANB can reduce the incidence of dyspnea more than ISB. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/34520842/Efficacy_and_safety_of_suprascapular_nerve_block_combined_with_axillary_nerve_block_for_arthroscopic_shoulder_surgery:_A_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -