Ultrasound Guided Combined Suprascapular/Axillary Nerve Blocks Compared to Interscalene Nerve Block and Periarticular Infiltration for Arthroscopic Shoulder Surgery Analgesia | ||
| Al-Azhar International Medical Journal | ||
| Volume 2025, Issue 7, July 2025, Pages 124-129 PDF (514.47 K) | ||
| Document Type: Original Article | ||
| DOI: https://doi.org/10.21608/aimj.2025.446647 | ||
| Authors | ||
| Mohamed Osama Ahmed Mohamed Aboseada1; Ali AbdAllah AbdAllah Alkumity2; Mohamed Fathy Fahmy El-halawany3; Ibrahim AbdElraof Mohamed Elsayed Bashter* 4 | ||
| 1Professor of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 2Lecturer of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 3Lecturer of orthopedics , Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 4MSc., Anesthesia and Intensive care, Assisstant Lecturer of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University Hospitals, Cairo, Egypt | ||
| Abstract | ||
| Background: Minimally invasive arthroscopic shoulder surgery causes significant intra- and postoperative pain. Regional analgesia lowers anesthesia and surgical discomfort, speeding recovery. Aim and objectives: When it comes to arthroscopic shoulder surgeries, there are two methods that have been compared for their effectiveness: ultrasound-guided combined suprascapular/axillary nerve and interscalene block and periarticular infiltration. The comparison will focus on intraoperative hemodynamic stability, opioid requirements, and postoperative pain. Factors such as total analgesic used, pain scores, patient satisfaction, and complications were also important in the secondary aim. Patients and methods: The subjects of this prospective, randomized, double-blind trial were 105 individuals who, between 2023 and 2024, had unilateral arthroscopic shoulder surgeries performed as elective procedures at Al-Azhar University Hospitals. Results: At 15 minutes, 90 minutes, 105 minutes, and the completion of surgery, there was no significant difference in heart rate (HR) and mean arterial pressure (MAP) between the three groups. The group's interscalene brachial plexus block (ISB) and shoulder block (ShB) substantially reduced HR and MAP at 30 minutes, 45 minutes, and 60 minutes compared to the group PAB. Both groups showed considerably reduced HR and MAP at 75 minutes compared to the group that underwent periarticular block (PAB) (P-value<0.05), although there was no significant difference between the two groups. Conclusion: While both PAB and ultrasound-guided combined suprascapular/axillary nerve and ISB improve hemodynamics, the former is more effective in reducing pain scores, total opioid consumption, and cortisol levels in patients undergoing arthroscopic shoulder surgery, while the latter is preferred by the majority. | ||
| Keywords | ||
| Ultrasound; Arthroscopic shoulder surgery | ||
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