The use of combined suprascapular and circumflex (articular branches) nerve blocks in the management of chronic arthritis of the shoulder joint

Abstract

Sixteen patients suffering from rheumatoid or osteoarthritis of the shoulder joint were studied. All patients complained of pain and limitation of active movement of the shoulder joint. Combined neural blockade of the suprascapular nerve (SSNB) and articular branches of the circumflex nerve (ACNB) was carried out using 4 mL of 1% prilocaine and 4 mL of 6% aqueous phenol. Following this procedure, the mean value for pain intensity decreased by 69% (VASP 2.7) and for abduction, adduction and flexion increased by 36–67% over a mean time of 13 weeks. Functional external and internal rotation of the shoulder joint also increased after neural blockade. These findings were significant (P<0.05). Further clinical evaluation of combined SSNB and ACNB in relation to previously reported methods of neural blockade of the shoulder joint is warranted using a randomized, controlled, comparative study. Conventional power calculations (80% power, 5% test) indicate that 17 patients per group would be necessary to detect one standard deviation (about 2 VASP) or 64 per group to detect a change of 0.5 standard deviations.