The Analgesic Effect of (SHAC) Block Versus Suprascapular Nerve Block in Arthroscopic Shoulder Surgeries

The Analgesic Effect of Shoulder Anterior Capsule (SHAC) Block Versus Suprascapular Nerve Block in Arthroscopic Shoulder Surgeries

The aim of the study is to compare the post-operative analgesic effect of Shoulder anterior capsule (SHAC) block with Suprascapular nerve block for arthroscopic shoulder surgery with a hypothesis that both Shoulder anterior capsule (SHAC) block and Suprascapular nerve block are effective in providing postoperative analgesia for arthroscopic shoulder surgery.

The role of shoulder arthroscopy in the diagnosis and treatment of shoulder disorders is evolving .

Advances in modern arthroscopy have contributed significantly to greater flexibility and efficacy in addressing shoulder pathology.Advantages of arthroscopy include less invasive approaches, improved visualization, decreased risk of many postoperative complications ,and faster recovery.

Shoulder surgery is well recognised as having the potential to cause severe postoperative pain.The aim of this review is to assess critically the evidence relating to the effectiveness of regional anaesthesia techniques commonly used for postoperative analgesia following shoulder surgery opioid analgesics are commonly used for analgesia when nerve block are not used. opoids are effective in relieving postoperative pain at rest but may increase postoperative nausea and vomiting (PONV),somnolence,constipation,urinary retention,respiratory depression ,and sleep disturbances.

supplementing general anesthesia (GA) with a regional nerve block might improve the quality of postoperative relief pain .

Throughout intraoperative and postoperative period, nerve blocks have been used more populary than others because of efficacy.For the regional nerve block,local anesthetic should be infiltrated close to the nerve for maximum effect.

Shoulder anterior capsule block (SHAC):is combination of two different blocks .the first block is the interfascial space between the deep layer of the deltoid fascia and the superficial layer of the subscapularis fascia , anterior to the subscapularis myotendinous junction . Thanks to this interfascial space,we can reach both the axillary nerve and the subscapular nerves,the lateral pectoral nerve and the musculocutaneous nerve.

Suprascapular nerve block(SSB) :The suprascabular nerve (SSN) originates from the nerve roots and provides sensation for the posterior shoulder capsule, acromioclavicular joint,subacromial bursa,and coracoclavicular ligament .Blocking it provides pre-emptive anesthesia , decreased intraoperative pain ,and postoperative pain relief in shoulder arthroscopy.

Inclusion Criteria:

• -Age between 18-65 years.
• Body mass index (BMI)of 18-35Kg /m2.
• Patients with American society of anesthesiologist (ASA) physical status | / ||.
• Patients scheduled for elective Arthroscopic Shoulder Surgery.
• Both sexes, males and females.

Exclusion Criteria:

• -Patient refusal.

• Allergy to local anaesthetics.

• Infection at the site of injection .

• Coagulopathy.

• Chronin pain syndromes.

• Prolonged opioid medication

  .-Patients who received any analgesia 24 h before surgery.

• pregnancy