A New Anterior Approach for Fluoroscopy-guided Suprascapular Nerve Block - A Preliminary Report -

Area of Science:

• Pain Management
• Interventional Radiology
• Anesthesiology

Background:

• Chronic shoulder pain significantly impacts quality of life.
• Suprascapular nerve block (SSNB) is a treatment option for shoulder pain.
• Evaluating novel techniques for SSNB is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the feasibility of a fluoroscopy-guided anterior approach for suprascapular nerve block (SSNB).
• To determine the efficacy of this technique in managing chronic shoulder pain.
• To evaluate the safety profile of the fluoroscopic anterior SSNB.

Main Methods:

• Twenty patients with chronic shoulder pain received SSNB via a fluoroscopy-guided anterior approach.
• A tunnel view technique was employed using specific fluoroscopic angles for optimal scapular notch visualization.
• Contrast confirmed needle placement before injecting 1% mepivacaine, with pain assessed using the Numerical Rating Scale (NRS).

Main Results:

• Significant reduction in average NRS pain scores from 4.8 to 0.6 post-procedure (P < 0.05).
• Optimal scapular notch visualization achieved with specific medial (15.1°) and caudal (15.4°) fluoroscopic angles.
• The technique demonstrated a favorable safety profile, with no pneumothorax, intravascular injection, or hematoma observed.

Conclusions:

• Fluoroscopy-guided anterior SSNB is a feasible and effective technique for treating chronic shoulder pain.
• Accurate needle placement in the scapular notch is facilitated by fluoroscopy, allowing for effective pain relief with minimal anesthetic volume.
• This approach offers a safe alternative, avoiding complications such as pneumothorax.