title: In select patients, ipsilateral post-thoracotomy shoulder pain relieved by suprascapular nerve block.
abstract: Shoulder pain following thoracotomy is a common postoperative complaint and can be difficult to treat. This article explores how to select patients who would benefit from a suprascapular nerve block for post-thoracotomy shoulder pain. A retrospective case review of 178 patients who underwent thoracotomy at our institution was performed. Only patients with elicitable local signs of musculoskeletal shoulder pain were offered a suprascapular nerve block with 10 cc of 0.25% bupivicaine. Of 178 patients, 92 (51.7%) complained of post-thoracotomy shoulder pain. Of these patients, 34 (37.0%) had localizing signs of musculoskeletal shoulder pain and underwent suprascapular nerve block. Twenty-nine of 34 (85.3%) patients obtained satisfactory pain relief. We estimate a true-positive rate of 85.3% with a 95% confidence interval of (68.9%, 95.0%) for those patients who received relief from suprascapular nerve block after localizing signs on physical examination of the shoulder. Patients post-thoracotomy with local signs of shoulder pain on physical examination may benefit from suprascapular nerve blocks in the immediate postoperative period.
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Suparna
authors.initials: S
authors.lastname: Saha
authors.forename: Eldor L
authors.initials: EL
authors.lastname: Brish
authors.forename: Angus M
authors.initials: AM
authors.lastname: Lowry
authors.forename: Krishna
authors.initials: K
authors.lastname: Boddu
mesh_terms: D000779:Anesthetics, Local; D002045:Bupivacaine; D006801:Humans; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D012189:Retrospective Studies; D012540:Scapula; D020069:Shoulder Pain / Q000209:etiology / Q000628:therapy*; D013908:Thoracotomy; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine