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Kang SS, Jung JW, Song CK, et al. A New Anterior Approach for Fluoroscopy-guided Suprascapular Nerve Block - A Preliminary Report -. Korean J Pain. 2012;25(3):168-72doi: 10.3344/kjp.2012.25.3.168.
Kang, S. S., Jung, J. W., Song, C. K., Yoon, Y. J., & Shin, K. M. (2012). A New Anterior Approach for Fluoroscopy-guided Suprascapular Nerve Block - A Preliminary Report -. The Korean journal of pain, 25(3), 168-72. https://doi.org/10.3344/kjp.2012.25.3.168
Kang, Sang Soo, et al. "A New Anterior Approach for Fluoroscopy-guided Suprascapular Nerve Block - A Preliminary Report -." The Korean journal of pain vol. 25,3 (2012): 168-72. doi: https://doi.org/10.3344/kjp.2012.25.3.168
Kang SS, Jung JW, Song CK, Yoon YJ, Shin KM. A New Anterior Approach for Fluoroscopy-guided Suprascapular Nerve Block - A Preliminary Report -. Korean J Pain. 2012 Jul;25(3):168-72. doi: 10.3344/kjp.2012.25.3.168. Epub 2012 Jun 28. PMID: 22787547; PMCID: PMC3389321.
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Korean J Pain. 2012 Jul;25(3):168-72. doi: 10.3344/kjp.2012.25.3.168. Epub 2012 Jun 28.

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

The Korean journal of pain

Sang Soo Kang, Jae Woo Jung, Chang Keun Song, Young Jun Yoon, Keun Man Shin

Affiliations

  1. Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

PMID: 22787547 PMCID: PMC3389321 DOI: 10.3344/kjp.2012.25.3.168

Abstract

BACKGROUND: The aim of the study was to investigate the feasibility of fluoroscopy-guided anterior approach for suprascapular nerve block (SSNB).

METHODS: Twenty patients with chronic shoulder pain were included in the study. All of the nerve blocks were performed with patients in a supine position. Fluoroscopy was tilted medially to obtain the best view of the scapular notch (medial angle) and caudally to put the base of coracoid process and scapular spine on same line (caudal angle). SSNB was performed by introducing a 100-mm, 21-gauge needle to the scapular notch with tunnel view technique. Following negative aspiration, 1.0 ml of contrast was injected to confirm the scapular notch, and 1 % mepivacaine 2 ml was slowly injected. The success of SSNB was assessed by numerical rating scale (NRS) before and after the block.

RESULTS: The average NRS was decreased from 4.8 ± 0.6 to 0.6 ± 0.5 after the procedure (P < 0.05). The best view of the scapular notch was obtained in a medial angle of 15.1 ± 2.2 (11-19°) and a caudal angle of 15.4 ± 1.7° (12-18°). The average distance from the skin to the scapular notch was 5.8 ± 0.6 cm. None of the complications such as pneumothorax, intravascular injection, and hematoma formation was found except one case of partial brachial plexus block.

CONCLUSIONS: SSNB by fluoroscopy-guided anterior approach is a feasible technique. The advantage of using a fluoroscopy resulted in an effective block with a small dose of local anesthetics by an accurate placement of a tip of needle in the scapular notch while avoiding pneumothorax.

Keywords: contrast media; fluoroscopy; nerve block; shoulder pain

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