Serratus Posterior Superior Intercostal Plane Block Versus Suprascapular Nerve Block and Axillary Nerve Block for Analgesia in Shoulder Arthroscopic Surgery

Controlling postoperative pain while minimizing opioid administration is particularly important because poor pain control is thought to be responsible for more than 60% of unplanned or prolonged hospitalizations.

Suprascapular nerve block (SSNB) has been proposed based on the anatomic fact that the suprascapular nerve innervates approximately 70% of the shoulder joint, capsule, subacromial space, acromioclavicular joint, and coracoacromial ligament, with the remaining 30% thought to be innervated by the lateral pectoral and axillary nerve.

The combined SSNB and axillary nerve block (ANB) was proposed as a safe alternative to interscalene brachial plexus block (ISB) for providing anesthesia and postoperative analgesia for shoulder surgery.

Serratus posterior superior intercostal plane block (SPSIPB) was described as a novel technique in a case series study of cadavers and five patients.

Inclusion criteria

• Age from 18 to 65 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Scheduled for open thoracotomy.

Exclusion criteria

• Infection at the site of regional blocks.
• Allergy to any drug used in this study.
• Use of psychotropic and/or narcotic medications on a regular basis.
• Cognitive dysfunction.
• Cardiovascular disease.
• Pulmonary disease.
• Coagulation abnormalities.
• Anatomical abnormalities.
• Neuropathic pain.
• Body mass index >40.
• History of substance abuse.
• Previous surgery in the same shoulder.