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Suprascapular nerve block and axillary nerve block versus interscalene nerve block for arthroscopic shoulder surgery: A meta-analysis of randomized controlled trials.
Medicine (Baltimore). 2021 Nov 05; 100(44):e27661.M

Abstract

BACKGROUND

The interscalene brachial plexus block (ISB) is a commonly used nerve block technique for postoperative analgesia in patients undergoing shoulder arthroscopy surgery; however, it is associated with potentially serious complications. The use of suprascapular nerve block (SSNB) and axillary Nerve Block (ANB) has been reported as an alternative nerve block with fewer reported side effects for shoulder arthroscopy. This review aimed to compare the impact of SSNB and ANB with ISB during shoulder arthroscopy surgery.

METHODS

A meta-analysis was conducted to identify relevant randomized or quasirandomized controlled trials involving SSNB and ISB during shoulder arthroscopy surgery. We searched Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database from 2010 through August 2021.

RESULTS

We identified 641 patients assessed in 10 randomized or quasirandomized controlled trials. Compared with the ISB group, the SSNB+ANB group had higher visual analog scale or numerical rating scale in PACU (P = .03), 4 hour (P = .001),6 hour after the operation (P = .002), and lower incidence of complications such as Numb/Tingling (P = .001), Weakness (P <.00001), Horner syndrome (P = .001) and Subjective dyspnea (P = .002). No significant difference was found for visual analog scale or numerical rating scale 8 hour (P = .71),12 hour (P = .17), 16 hour (P = .38),1day after operation (P = .11), patient satisfaction (P = .38) and incidence of complications such as hoarseness (P = .07) and nausea/vomiting (P = .41) between 2 groups.

CONCLUSION

Our high-level evidence has established SSNB+ ANB as an effective and safe analgesic technique and a clinically attractive alternative to interscalene block during arthroscopic shoulder surgery, especially for severe chronic obstructive pulmonary disease, obstructive sleep apnea, and morbid obesity. Given our meta-analysis's relevant possible biases, we required more adequately powered and better-designed randomized controlled trial studies with long-term follow-up to reach a firmer conclusion.

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Authors+Show Affiliations

Sun C
Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China.
Zhang X
Department of Clinical Epidemiology and Biostatistics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine,Tsinghua University, No.168 Litang Road, Dongxiaokou Town,Changping District, Beijing, China.
Ji X
Department of Anesthesia, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Institutional address: No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China.
Yu P
Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China.
Cai X
Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China.
Yang H
Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China.

MeSH

Anesthetics, LocalArthroscopyAxillaBrachial Plexus BlockHumansPain, PostoperativeRandomized Controlled Trials as TopicShoulder

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

34871240

Citation

Sun, Changjiao, et al. "Suprascapular Nerve Block and Axillary Nerve Block Versus Interscalene Nerve Block for Arthroscopic Shoulder Surgery: a Meta-analysis of Randomized Controlled Trials." Medicine, vol. 100, no. 44, 2021, pp. e27661.
Sun C, Zhang X, Ji X, et al. Suprascapular nerve block and axillary nerve block versus interscalene nerve block for arthroscopic shoulder surgery: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021;100(44):e27661.
Sun, C., Zhang, X., Ji, X., Yu, P., Cai, X., & Yang, H. (2021). Suprascapular nerve block and axillary nerve block versus interscalene nerve block for arthroscopic shoulder surgery: A meta-analysis of randomized controlled trials. Medicine, 100(44), e27661. https://doi.org/10.1097/MD.0000000000027661
Sun C, et al. Suprascapular Nerve Block and Axillary Nerve Block Versus Interscalene Nerve Block for Arthroscopic Shoulder Surgery: a Meta-analysis of Randomized Controlled Trials. Medicine (Baltimore). 2021 Nov 5;100(44):e27661. PubMed PMID: 34871240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suprascapular nerve block and axillary nerve block versus interscalene nerve block for arthroscopic shoulder surgery: A meta-analysis of randomized controlled trials. AU - Sun,Changjiao, AU - Zhang,Xiaofei, AU - Ji,Xiaolin, AU - Yu,Peng, AU - Cai,Xu, AU - Yang,Huadong, PY - 2020/10/05/received PY - 2021/10/14/accepted PY - 2021/12/6/entrez PY - 2021/12/7/pubmed PY - 2022/1/27/medline SP - e27661 EP - e27661 JF - Medicine JO - Medicine (Baltimore) VL - 100 IS - 44 N2 - BACKGROUND: The interscalene brachial plexus block (ISB) is a commonly used nerve block technique for postoperative analgesia in patients undergoing shoulder arthroscopy surgery; however, it is associated with potentially serious complications. The use of suprascapular nerve block (SSNB) and axillary Nerve Block (ANB) has been reported as an alternative nerve block with fewer reported side effects for shoulder arthroscopy. This review aimed to compare the impact of SSNB and ANB with ISB during shoulder arthroscopy surgery. METHODS: A meta-analysis was conducted to identify relevant randomized or quasirandomized controlled trials involving SSNB and ISB during shoulder arthroscopy surgery. We searched Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database from 2010 through August 2021. RESULTS: We identified 641 patients assessed in 10 randomized or quasirandomized controlled trials. Compared with the ISB group, the SSNB+ANB group had higher visual analog scale or numerical rating scale in PACU (P = .03), 4 hour (P = .001),6 hour after the operation (P = .002), and lower incidence of complications such as Numb/Tingling (P = .001), Weakness (P <.00001), Horner syndrome (P = .001) and Subjective dyspnea (P = .002). No significant difference was found for visual analog scale or numerical rating scale 8 hour (P = .71),12 hour (P = .17), 16 hour (P = .38),1day after operation (P = .11), patient satisfaction (P = .38) and incidence of complications such as hoarseness (P = .07) and nausea/vomiting (P = .41) between 2 groups. CONCLUSION: Our high-level evidence has established SSNB+ ANB as an effective and safe analgesic technique and a clinically attractive alternative to interscalene block during arthroscopic shoulder surgery, especially for severe chronic obstructive pulmonary disease, obstructive sleep apnea, and morbid obesity. Given our meta-analysis's relevant possible biases, we required more adequately powered and better-designed randomized controlled trial studies with long-term follow-up to reach a firmer conclusion. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/34871240/Suprascapular_nerve_block_and_axillary_nerve_block_versus_interscalene_nerve_block_for_arthroscopic_shoulder_surgery:_A_meta_analysis_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓3 ↑23]

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