Ultrasound Guided Subscapularis and Subomohyoid Plane Blocks versus Interscalene Block with Levobupivacaine for Analgesia in Shoulder Surgery

• Published in: QJM : An International Journal of Medicine Vol. 117; no. Supplement_1
• Main Authors: Nassar, Mohamed Zakaria, Ghobrial, Bassem Boulos, Shoukry, Randa Ali, Mohamed Abdou, Khaled Mohamed Ahmed
• Format: Journal Article
• Language: English
• Published: 03.07.2024
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcae070.027

Abstract Background Now Shoulder surgery is a common procedure, particularly as it is associated with reduced hospitalization times, even though the technique may lead to moderate and severe postoperative pain. In recent years, various studies have been carried out that demonstrated the need for valid anaesthetic techniques that allow adequate control of postoperative pain and also favour early mobilization and rehabilitation. Subscabularis and subomohyoid plane blocks allow pain control after shoulder surgery while decreasing the need of opioids and pain medication after surgery. In contrast to interscalene brachial plexus block, subscabularis and subomohyoid plane blocks carry minor risks of intrathecal injection or post operative respiratory distress. Aim of the Work to compare analgesic efficacy of ultrasound guided subomohyoid and subscapularis plane blocks versus interscalene block using levobupivacaine in both techniques for pain control after shoulder surgery. Patients and Methods This exploratory randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent shoulder surgery under general anesthesia were included in the study their ages range between 21 and 65 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization and opaque sealed envelopes into two groups 30 patients in each (n = 30). Results In this study we find that combined subscapularis plane and sub-omohyoid injections may serve as an alternative to interscalene block for shoulder analgesia, with less complications. The present study shows no difference in the demographic data between the two groups (p-value >0.05). Also there was no statistically significant difference in the surgery duration between the two groups. But the duration of subomohyoid and subscapularis plane block was longer than the duration of interscalene block, the Mean± SD is (10.80±2.64 minutes) for subomohyoid and subscapularis plane blocks while interscalene block duration is (5.33±1.56 minutes) so there was astatically significant difference P-value <0.001. Conclusion Subscapularis plane and subomohyoid plane blocks can be used as an alternative shoulder analgesia with minor risks.