A Randomized Comparison Between Interscalene and Combined Interscalene-Suprascapular Blocks for Arthroscopic Shoulder Surgery: A Prospective Clinical Study

Background: To compare the analgesic effect of ISB with a combination of ISB-SSNB and patients who were given opioids withPCA without block in adult patients undergoing shoulder surgery, as measured by opioid consumption and pain intensity in the first 24hours postoperatively.Methods: Ninety patients who underwent shoulder surgery were randomly divided into three groups. Group I in which ISB wasperformed and patient-controlled analgesia (PCA) was inserted, Group II with; ISB and SSNB combined, and PCA was inserted, andGroup III where; only PCA was used. Visual analog scale (VAS) pain scores at the second, fourth, sixth, 12th, and 24th hours,morphine consumption, additional analgesic requirement, and patient satisfaction were evaluated.Results: Compared with Group III, the VAS pain score was significantly lower in Group I and Group II at 2, 4, 6, 12, and 24 hourspostoperatively. In Group I, the VAS score at rest at the 6th hour was found to be higher than in Group II. The 24-hour total morphineconsumption was higher in the control group than in Group I and Group II. The satisfaction score of the control group was lower thanGroup I and Group II.Conclusion: The combined application of ISB and SSNB block is beneficial in shoulder surgery to provide both intraoperative andpostoperative analgesia and opioid consumption.Level of Evidence: Level I; Randomized Controlled Trial; Treatment Study.Keywords: interscalene block, suprascapular nerve block, shoulder arthroscopic surgery, postoperative analgesia