Anterior and Posterior Approaches of Suprascapular Nerve Block

Comparison of Anterior and Posterior Approaches of Suprascapular Nerve Block in Arthroscopic Shoulder Surgery

Suprascapular nerve is a mixed motor and sensory peripheral nerve arising from the superior trunk of brachial plexus.The suprascapular nerve runs through the posterior triangle of the neck, anterior of the trapezius muscle and dorsal of the omohyoid muscle, in direction of the scapula. Suprascapular nerve block is performed by anterior and posterior approach. Posterior approach of the suprascapular nerve block has been shown for many years to provide effective analgesia in the shoulder region for the chronic and acute pain. There are studies showing that suprascapular block with anterior approach provides effective analgesia in shoulder arthroscopy.

The aim of our study was to compare anterior and posterior approaches of suprascapular nerve block in terms of analgesic efficacy and patient safety.

Study Overview

• Status: Completed
• Conditions: Postoperative Pain; Shoulder Pain; Diaphragmatic Paralysis; Suprascapular Nerve Block; Subomohyoid Suprascapular Nerve Block; Anterior Suprascapular Nerve Block
• Intervention / Treatment: Procedure: Posterior suprascapular block; Procedure: Anterior suprascapular block

Detailed Description

This study is a prospective randomized clinical trial will be conducted between July 2022 and June 2023.Participant will divide into two groups as participant who underwent suprascapular nerve block with the anterior approach and participant who underwent suprascapular nerve block with the posterior approach. Bupivacaine 5 ml %0.5 will be injected both group. Diaphragmatic thickness fraction will be evaluated with ultrasound left and right 7.-8. subcostal anterior axillary border with the participant with the semi-sitting position. Diaphragmatic thickness fraction will measure before the block and after 30 minutes the surgery. Participants will administered intravenous morphine patient controlled analgesia for 24 hours stay. The amount of opioid analgesics given in both groups will be determined (in mg). Postoperative 4th, 6th, 12th, 24th hour Visual Analogue Scale scores of the participants and opioid consumptions until that hours will be evaluated. An addition participant will be determined according to the surgery.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye), 34722
    • Istanbul Medeniyet University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 76 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient who accepts to study protocol
• Scheduled for shoulder surgery
• Between the ages of 18 and 80

Exclusion Criteria:

• Patients with coagulopathy
• Patients with a history of local anesthetic drug allergy and toxicity
• Patients with advanced organ failure
• Patients with mental retardation
• Patients with infection present at the injection site
• Patients with diaphragm paralysis
• Pregnant patients

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Posterior suprascapular block; Suprascapular block performed by posterior approach	Procedure: Posterior suprascapular block; Diaphragmatic thickness fraction will be evaluated in the participant underwent suprascapular block performed by posterior approach
Active Comparator: Anterior suprascapular block; Suprascapular block performed by anterior approach	Procedure: Anterior suprascapular block; Diaphragmatic thickness fraction will be evaluated in the participant underwent suprascapular block performed by anterior approach

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative pain at the postoperatively 30 Minutes, 4 Hours, 6Hours, 12Hours, 24Hours	Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel.	Up to 24 hours post-operative

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diaphragmatic movements	Ratio of diaphragm thickness in end-inspiration and end-expiration measured by ultrasonography	Baseline (Before the block performed) and 30 minutes after the end of surgery
Postoperative opioid analgesic consumption (morphine)	milligram	postoperative 4 hours
Postoperative opioid analgesic consumption (morphine)	milligram	postoperative 6 hours
Postoperative opioid analgesic consumption (morphine)	milligram	postoperative 12 hours
Postoperative opioid analgesic consumption (morphine)	milligram	postoperative 24 hours
Peroperatively opioid analgesic consumption (Remifentanil)	milligram	up to postoperative 0 minutes
Postoperative opioid analgesic consumption (morphine)	milligram	postoperative 30 minutes
Postoperative pain at postoperative 4 Hours	Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel.	at postoperative 4 Hours
Postoperative pain at postoperative 6 Hours	Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel.	at postoperative 6 Hours
Postoperative pain at postoperative 12 Hours	Visual analogue scale (0-10): 0= no pain, 10= the worst pain ever feel.	at postoperative 12 Hours
Postoperative pain at postoperative 24 Hours	Visual analog scale (0-10): 0= no pain, 10= the worst pain ever feel.	at postoperative 24 Hours

Collaborators and Investigators

• Sponsor: Istanbul Medeniyet University
• Investigators: Principal Investigator: Ebru Girgin Dinç, MD, Istanbul Medeniyet University

Study record dates

Study Major Dates

• Study Start (Actual): July 11, 2022
• Primary Completion (Actual): June 15, 2023
• Study Completion (Actual): July 15, 2023

Study Registration Dates

• First Submitted: April 18, 2022
• First Submitted That Met QC Criteria: July 1, 2022
• First Posted (Actual): July 5, 2022

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 19, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Nerve Block; Postoperative pain; Shoulder pain; Diaphragmatic paralysis; Suprascapular block; Subomohyoid suprascapular block; Posterior Suprascapular block; Anterior Suprascapular block
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Nervous System Diseases; Postoperative Complications; Pathologic Processes; Joint Diseases; Respiratory Tract Diseases; Respiration Disorders; Arthralgia; Respiratory Insufficiency; Paralysis; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Shoulder Pain; Respiratory Paralysis
• Other Study ID Numbers: EDinc

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: After the article is accepted by the journal
• IPD Sharing Time Frame: After the article is accepted by the journal
• IPD Sharing Access Criteria: After the article is accepted by the journal
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No