A comparative study between Ultrasound guided anterior glenoid block combined with Subomohyoid Anterior Suprascapular Block versus Ultrasound guided interscalene block in diagnostic shoulder arthroscopy

Abstract

Background:Interscalene brachial plexus block (ISB), while considered the standard for analgesia in shoulder arthroscopy, often causes hemidiaphragmatic paresis, limiting its application in specific populations. The current study is dedicated to compare the analgesic efficiency, diaphragmatic function preservation, and motor power between a combination of sub-omohyoid anterior suprascapular block (SASB) and anterior glenoid block (AGB) versus ISB in individuals undergoing diagnostic shoulder arthroscopy.Methods:In the current prospective randomized controlled trial, 60 ASA I–II patients aged 18–65 years undergoing diagnostic shoulder arthroscopy were randomized into two groups (n = 30 each). Group A underwent SASB + AGB; Group B received ISB. The primary outcome was the degree of preserved diaphragmatic function (DPDF), measured via ultrasonographic excursion. Secondary outcomes included postoperative pain scores (NRS), degree of preserved handgrip strength (DPHS), and adverse events. Assessments were performed preoperatively and at 0, 4, 8, and 24 hours postoperatively.Results:Both groups demonstrated significant postoperative pain reduction with no significant difference in NRS scores (p > 0.05). Group A showed significantly better preservation of diaphragmatic function (p < 0.001) and hand motor power (p < 0.001) in comparison with Group B. No adverse events were reported in either group.Conclusion:SASB combined with AGB provides comparable analgesia to ISB in shoulder arthroscopy while offering superior preservation of diaphragmatic function and upper limb motor power. This technique may serve as a safer alternative in patients at risk for respiratory compromise or motor weakness.