A Comparison of Subacromial Bursae Block, Suprascapular Nerve Block and Interscalene Brachial Plexus Block after Arthroscopic Shoulder Surgery

Background: The aim of this study was to compare the analgesic efficacy of subacromial bursae block (LA), suprascapular nerve block (SSB), and interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Methods: 91 patients scheduled to undergo an arthroscopic shoulder acromioplasty under GA in an outpatient setting were included. The patients were prospectively randomized into 4 groups: 1) interscalene brachial plexus block, 2) suprascapular nerve block, 3) subacromial bursae block, 4) control group for comparison. Pain scores (VAS), supplemental analgesia, and side effects were recorded in the recoveryroom, 4 hours and 24 hours after surgery. Results: Group ISB had significantly lower pain scores at rest in the postanesthesia care unit than the SSB group (p = 0.037) and the control group (p = 0.0313). The same results were seen 4 hours follow-up. The LA group had significantly lower pain scores at rest in the postanesthesia care unit than the control group (p = 0.046) and after 4 hours follow-up significantly lower pain scores than both the SSB group (p = 0.021) and the control group (p = 0.037). After 24 hours, there were no differences between the two groups. Conclusion: In this prospective, randomized, blinded study we demonstrated that a single-dose interscalene brachial plexus block (ISB) and a subacromial bursae block (LA) are equal and the most efficient analgesic techniques after arthroscopic shoulder acromioplasty. LA is less expensive, faster and with fewer complications than ISB and therefore we suggest subacromial bursae block is an effective, safe and easy way of postoperative pain reduction after arthroscopic acromioplasty. Level of evidence: Level I. Treatment study.