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suprascapular nerve block anterior approach

Suprascapular nerve block(SSN), anterior approach: SSN block can be used as alternative to ISBP block for shoulder surgery, especially if we want to avoid phrenic nerve block. SSN take off of Superior trunk (C5,6) and passes under inferior belly of omohyoid inferiorly and posteriorly from the brachial plexus to pass underneath the coracoclavicular ligament and then under the superior transverse ligament as it passes through the suprascapular notch and innervates the supraspinatus and infraspinatus muscles, as well as the acromioclavicular and glenohumeral joints. SSN provides 70% of sensory innervation to the shoulder joint. Indications: Acute shoulder pain(postoperative), Chronic shoulder pain. Suprascapular nerve block also is useful as an adjunctive therapy for treatment of decreased range of motion of the shoulder secondary to reflex sympathetic dystrophy or adhesive capsulitis. Suprascapular nerve block can be used to allow more aggressive physical therapy after shoulder reconstruction surgery. 28 years old male, complaining from chronic left shoulder pain after left shoulder joint stabilization. patient neglected postoperative physiotherapy, so has limited range of movement. US guided left suprascapular nerve block with catheter is used for analgesia and facilitation of physiotherapy. Ultrasound machine: Samsung HS60. Probe: liner HF 4-18 Needle: E-cath 51mm, 18G, echogenic. Patient position: supine with head tilt (in this case head turned to Rt side) Local Anesthesia: 0.2-0.5% Ropivacaine(5-10 ml depending on concentration used) Probe: high frequency Linear probe, Landmark: inferior belly of Omohyoid Muscle.