Date of Award
1-1-2022
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
Objective: The objective of this selective EBM review is to determine whether or not “Does administration of an anterior suprascapular nerve block improve post-operative pain and reduce opioid consumption when compared to traditional interscalene nerve plexus block in adults undergoing arthroscopic shoulder surgery.”
Study Design: A review of three randomized controlled trials (RCTs) published in English between 2017-2020.
Data Sources: All three articles used are peer-reviewed RCTs that were discovered using PubMed. The articles were evaluated and selected based on their ability to answer the proposed clinical question.
Outcome Measured: All three articles measured and compared post-operative pain using numerical rating scale (NRS) with a higher number on the scale indicating a higher rating of pain. The articles also measured and compared the total amount of opioid consumption by using direct measurement and logging.
Results: In the RCT led by Auyong et al., the suprascapular (SS) approach was not statistically significant (P=0.388) vs. interscalene (IS) control in regard to total opioid consumption interoperatively up until 60 mins post operatively. The SS was not statistically significant (P=0.337) vs. IS in regard to average postoperative pain score at 60 minutes. In the RCT led by Lim et al., the SS was not statistically significant (P=0.099) vs. IS in regard to total opioid consumption in the first 24 hours following surgery. The SS was statistically significant vs. IS in regard to average postoperative pain score at 1 hour with movement (P=0.027) and not significant (P= 0.068) without movement. In the RCT led by Weigle et al., the SS was not statistically significant (P=0.63) vs. IS in regard to total opioid consumption while in the PACU. The SS was not statistically significant (P=0.42) vs. IS in regard to average postoperative pain score at 30 minutes.
Conclusion: All three studies in this review demonstrated that pain control and opioid consumption is similar between the two anesthetic techniques of surgery and doesn’t convey significant clinical importance when comparing the two anesthetic techniques. Further studies should explore different populations with underlying illnesses that may favor one anesthetic technique over the other.
Recommended Citation
Trobetsky, Tyler, "Does Administration of An Anterior Suprascapular Nerve Block Improve Post-Operative Pain And Reduce Opioid Consumption When Compared To Traditional Interscalene Nerve Plexus Block In Adults Undergoing Arthroscopic Shoulder Surgery?" (2022). PCOM Physician Assistant Studies Student Scholarship. 647.
https://digitalcommons.pcom.edu/pa_systematic_reviews/647