Efficacy of suprascapular nerve block compared with subacromial injection: a randomized controlled trial in patients with rotator cuff tears.

Autor: Coory JA; Townsville Hospital, Douglas, QLD, Australia. Electronic address: jcoory@gmail.com., Parr AF; Townsville Hospital, Douglas, QLD, Australia., Wilkinson MP; Townsville Hospital, Douglas, QLD, Australia., Gupta A; Townsville Hospital, Douglas, QLD, Australia; Greenslopes Private Hospital, Brisbane, QLD, Australia.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2019 Mar; Vol. 28 (3), pp. 430-436. Date of Electronic Publication: 2019 Jan 14.
DOI: 10.1016/j.jse.2018.11.051
Abstrakt: Hypothesis: We aimed to compare the clinical efficacy of a suprascapular nerve block (SSNB) versus subacromial injection (SA) for outpatient treatment of patients with symptomatic rotator cuff tears in a double-blinded, randomized controlled trial using sealed-envelope randomization.
Methods: A total of 42 participants with symptomatic partial- and full-thickness rotator cuff tears quantified by ultrasound or magnetic resonance imaging received either an ultrasound-guided SSNB or SA. The primary outcome measure was shoulder function measured by the modified Constant-Murley (CM) score and the secondary outcome was the pain score measured by a visual analog scale at 2, 6, and 12 weeks after injection.
Results: We analyzed 43 shoulders (27 in male patients, 62.2%). The mean age was 65.2 years (standard deviation [SD], 11.9 years). Of the shoulders, 22 (51.2%) underwent SAs and 21 (48.8%) underwent SSNBs. Continuous variables were analyzed by an independent t test (2 tailed), and nominal data were analyzed by the Fisher exact test (1 sided). At 6 weeks, the mean change from the baseline CM score was significantly higher in the SSNB group than in the SA group (14.3 [SD, 18.1] vs 3.0 [SD, 12.8]; P = .048). At 12 weeks' follow-up, the SSNB group had a significantly higher CM score than the SA group (57.6 [SD, 10] vs 44.6 [SD, 16]; P = .023) and greater improvement from the baseline CM score (23.4 [SD, 17.5] vs 7.8 [SD, 16.5]; P = .014). At 12 weeks, the visual analog scale score was significantly better in the SSNB group than in the SA cohort (9.9 [SD, 3.3] vs 7.3 [SD, 4.3]; P = .03).
Conclusions: This study demonstrates that an SSNB resulted in better pain and functional results than an SA at 6 and 12 weeks for symptomatic rotator cuff tears.
(Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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