A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction.
OBJECTIVE
Dislocation of the shoulder joint is one of the most common dislocations. The reduction procedure is a painful procedure. In this study, 2 different treatment groups were compared for pain control during shoulder dislocation reduction. It was aimed to evaluate the differences between the groups in reduction, success, length of hospital stay, complications, side effects, patient-physician satisfaction, and ease of application.


METHODS
The study was planned to be prospective and randomized. As procedural sedation analgesia (SA), titration of ketamine 1 to 2 mg/kg was administered intravenously to group 1. Suprascapular nerve block (SNB) was applied under ultrasound guidance (USG) to group 2. Conformity to normal distribution of variables was examined with the Kolmogorov-Smirnov test. The χ2 test and Fisher test were used to evaluate differences between the groups in categorical variables and the Mann-Whitney U test, and a value of P<.05 was accepted as statistically significant.


RESULTS
The study comprised a total of 41 patients; 20 in the group 1 and 21 in the group 2. No statistically significant difference was determined between the groups in terms of age (P=.916), sex (P=.972), reduction success (P=.540), and patient-physician satisfaction (P=.198). The time spent in the emergency department (ED) by patients in the SA group was signficantly longer compared with the SNB group. No side effects were observed in the SNB group.


CONCLUSIONS
Suprascapular nerve block, which can be easily applied under USG in the ED, can be evaluated as a good alternative to SA in the reduction of shoulder dislocations.
Department of Emergency Medicine, Gulhane Military Medical Academy, 06018 Ankara, Turkey.
Onur
O
Tezel
Department of Emergency Medicine, Gulhane Military Medical Academy, 06018 Ankara, Turkey. Electronic address: umitkaldirim@hotmail.com.
Umit
U
Kaldirim
Department of Orthopedics and Traumatology, Gulhane Military Medical Academy Haydarpasa Educational Hospital, Istanbul, Turkey.
Serkan
S
Bilgic
Department of Anesthesiology and Reanimation, Gulhane Military Medical Academy Haydarpasa Educational Hospital, Istanbul, Turkey.
Suleyman
S
Deniz
Department of Emergency Medicine, Gulhane Military Medical Academy, 06018 Ankara, Turkey.
Yusuf Emrah
YE
Eyi
Aksaz Military Hospital Department of Orthopedics and Traumatology, Mugla, Turkey.
Selahattin
S
Ozyurek
Department of Emergency Medicine, Gulhane Military Medical Academy, 06018 Ankara, Turkey.
Murat
M
Durusu
Department of Physical Therapy and Rehabilitation Diskapi Hospital, Ankara, Turkey.
Nihal
N
Tezel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D012782:Shoulder / Q000294:innervation; D012783:Shoulder Dislocation / Q000628:therapy*; D018084:Ultrasonography, Interventional; D055815:Young Adult