Comparison of Analgesic Efficacy of Phrenic Nerve Sparing Blocks Versus Interscalene Block for Postoperative Analgesia in Shoulder Surgeries

Kamel, Reda Khalil; Abdelmaksoud, Omar Mohy Eldin; Abdelrahman, Ahmed Hamdi; Abdou Elshazly, Khalid Reda

doi:10.21608/bjas.2025.341226.1543

Comparison of Analgesic Efficacy of Phrenic Nerve Sparing Blocks Versus Interscalene Block for Postoperative Analgesia in Shoulder Surgeries

Document Type : Original Research Papers

Authors

¹ Head of department and Professor of Anaesthesia and ICU, Faculty of Medicine, Benha University

² Professor of Anaesthesia and ICU, Faculty of Medicine, Benha University

³ Lecturer of Anaesthesia and ICU, Faculty of Medicine, Benha University

⁴ (M.B.B.Ch, Faculty of Medicine, Benha University)

10.21608/bjas.2025.341226.1543

Abstract

Background: To alleviate discomfort after shoulder surgery, a safe effective procedure is the interscalene brachial plexus block, or ISB. In two separate methods, the combined Suprascapular Nerve Block Axillary Nerve Block the combined Suprascapular Nerve Block Infraclavicular Block, were compared to the analgesic effectiveness of ISB ShaB phrenic nerve sparing blocks. Identifying the most effective means of pain relief after shoulder operations is the driving force for this comparison. All subjects in this prospective study will have arthroscopic surgery on one side of their shoulders. Three groups of equal numbers of patients were each given a different injection of bupivacaine: one group received 10 ml of 0.5% bupivacaine to block the axillary suprascapular nerves; the second group received 10 ml of 0.5% bupivacaine to block the infraclavicular suprascapular nerves; the third group received 10 ml of 0.5% bupivacaine to administer an ISB. There was a substantial difference in the time it took for groups 3 1 2 to first need analgesic rescue (P value <0.001). Group 3's total morphine intake was much lower than groups 1 2, even though there was no difference between the first two (P value=0.023 0.005, respectively). Results showed that the ISB group benefited more from the treatments than groups 1 2. There was a strong association between the therapies improvements in pulmonary function, hemodynamic stability, pain alleviation, opiate intake. There is evidence from studies like these that suggests these treatments may improve patients' health speed up their recoveries.

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