EFFICACY AND SAFETY OF ULTRASOUND GUIDED INTERSCALENE BLOCK VERSUS COMBINED SUPRASCAPULAR AND AXILLARY NERVE BLOCKS FOR PAIN RELIEVE FOR ARTHROSCOPIC SHOULDER SURGERY

Arthroscopic shoulder surgeries result in significant intraoperative and postoperative pain.This pain can be severe enough to interfere with postoperative mobility, may lead to prolonged hospital stay and delayed hospital discharge. .(1) Pre-emptive analgesia is an optimum analgesic treatment that prevents establishment of central sensitization and altered central processing of afferent input that occur after incisional and inflammatory injuries. (2) For shoulder arthroscopy, regional anesthesia is better than general anesthesia (GA) because of the extended postoperative analgesia and rapid recovery towards discharge . (3) GA with a regional nerve block reduces intraoperative anesthetic requirements resulting in rapid recovery and reduction of postoperative pain [4]. On the basis of the fact that ISB provides anesthesia for the shoulder joint by blocking C5 and C6 nerve roots and most of the nerve supply to the shoulder from these two nerve roots are carried by two nerves - namely, the suprascapular and the axillary nerves - the shoulder block (ShB) that involves the combined block of these two specific nerves was proposed to provide anesthesia and postoperative analgesia for the shoulder surgery as a safe alternative to ISB(5)