Interscalene or suprascapular block in a patient with shoulder dislocation.


Kaya M., Eksert S., Akay S., Kantemir A., Keklikci K.

The American journal of emergency medicine, vol.35, 2017 (SCI-Expanded) identifier identifier identifier

Abstract

Shoulder dislocation is one of the most painful orthopedic emergencies. There are various peripheral nerve blockage methods used for pain management in shoulder dislocation. However, there is no consensus as to which method is superior. We compared the effectiveness and practicality of 2 methods: ultrasound-guided interscalene brachial plexus block (ISBPB) and suprascapular nerve block (SSNB), in this case report. A 21-year-oldmale patient presented to the emergency department (ED) for recurrent shoulder dislocation. We have given ultrasound-guided ISBPB to the same patient during his previous visit for left shoulder dislocation 3 months ago and reduced the visual analog scale from 85 to 40. This time, the patient received ultrasound-guided SSNB, and the visual analog scale was reduced to 45 from the initial score of 95. Both methods allowed easy reduction of the shoulder without any complication. We managed to provide similarly effective pain management in both methods and observed no complications. However, ISBPB requires more experience to perform compared to the SSNB and carries higher risk of complications due to its close proximity to the anatomical structures. Although both of these methods are similarly effective, we recommend using the ultrasound-guided SSNBmethod, which is easier to performand carries lower risk for complications, in the ED.