ULTRASOUND-GUIDED SUPRASCAPULAR NERVE BLOCK. A TECHNIQUE THAT DOES NOT DEPEND ON THE SUPRA SCAPULAR NOTCH
5 slide(s) – English – 2011-09-08
Title: Ultrasound-Guided Suprascapular Nerve Block. A technique that does not depend on the supra scapular notch.
Author(s): M. BELEIL1, A. Kibeida2, Prof D. Harmon2
Institute(s): 1ANAESTHESIA, REGIONAL HOSPITAL LIMERICK, LIMERICK, 2Anaesthesia, REGIONAL HOSPITAL LIMERICK, Limerick, Ireland
Text: Background and aims:
Nerve entrapment due to arthritis and degenerative disease is amongst the most difficult to treat. Suprascapular nerve entrapment is one of those conditions that can be crippling and can diminsh quality of life significantly. Nerve block offers great relief in these conditions and is known to greatly improve quality of life. The block is classically done under CT guidance or via a blind technique using anatomical landmarks. In this report we document a new guidance method much simpler than CT guidance and much more reliable than blind methods. It describes an ultrasound guidance technique which has not been reported previously. Our technique avoids the difficulty of having to identify the suprascapular notch. Huge variability in this structure has been reported.
The case was 62 years old lady who had been suffering from bilateral shoulder pain and tenderness for 2 years that did not respond to more conservative measures. Suprascpaular nerve block in this lady was done under aseptic conditions using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.). The transducer was placed in a transverse orientation over the base of the neck to identify the clavicle anteriorly and the suprascapular fossa posteriorly. The suprascapular fossa was traced laterally to the direction of the acormium and suprascapular notch. A 22G spinal needle was guided by real-time ultrasound imaging to the lateral aspect of the suprascapular fossa and 2.5% chirocaine and Triamcinalone was injected in the floor of the fossa. Doppler was used to avoid any intravascular injection.
This provided pain relief for a period of 4 months and no complications were reported.
Utrasound guidance is much simpler and more reliable and provides comparable pain relief
Ethical Committee Approval: Acquired
Author Keywords: Ultrasound-Guided Suprascapular Nerve Block