Comparative Analgesia and Respiratory Effects of Shoulder Blocks

Analgesic Efficacy and Respiratory Effects of Interscalene, Anterior Suprascapular, and Pericapsular Nerve Group Blocks in Shoulder Arthroscopy

Interscalene block is widely accepted as the gold-standard regional analgesic technique for pain control after arthroscopic shoulder surgery. However, because this block is performed at the level of the brachial plexus roots, it may be associated with adverse effects such as phrenic nerve blockade and subsequent diaphragmatic dysfunction. These limitations have prompted the search for alternative regional anesthesia techniques that can provide effective postoperative analgesia while preserving respiratory function.

The anterior suprascapular block, which covers a broad dermatomal distribution of the shoulder region, has been shown in some studies to provide sufficient analgesia as a standalone technique. In addition, the pericapsular nerve group (PENG) block of the shoulder-applied around the anterior capsule and performed at a distance from critical neurovascular structures that may lead to serious complications-may represent another potential analgesic option following arthroscopic shoulder procedures.

Therefore, this study aims to evaluate alternative regional block techniques in comparison with the interscalene block and to contribute to the identification of an optimal analgesic strategy after arthroscopic shoulder surgery.

Inclusion Criteria:

• Patients with ASA scores I-II-III
• Patients scheduled for elective arthroscopic shoulder surgery
• Patients who have been informed about the study and have given written consent will be included.

Exclusion Criteria:

• Those with a known allergy to local anesthetics
• Those with an infection at the application site
• Those with a severe coagulopathy disorder or anticoagulant use
• Those with contralateral phrenic nerve palsy or a serious pulmonary diagnosis
• Those with a history of chronic opioid use or neuropathic pain