Anatomical Evaluation of a Technique for Suprascapular Nerve Blockade

Introduction: Analgesia following shoulder surgery commonly uses interscalene nerve blockade. When contraindicated (i.e. respiratory compromise), suprascapular nerve blockade can provide a viable alternative. Although a number of techniques have been used, Barber in 2005 described a simple method using anatomical landmarks. While theoretically straightforward, substantive evidence supporting the advantages attributed to the technique has yet to be identified. The present study anatomically examines the technique proposed by Barber to critically assess its potential to benefit clinical practice. Materials and Methods: Using the technique proposed by Barber in 2005, the Nevaiser portal was used to introduce a K-wire into the supraspinous fossa in the region of the suprascapular nerve. A spinal needle was inserted in the same manner and left in position in the presumed region of the transverse scapular ligament. Tissue was dissected out around the wire and needle to visualize their proximity to the suprascapular nerve and transverse scapular ligament respectively. Results: The K-wire was consistently located close to the suprascapular nerve with all cases being within 5 mm. Spinal needle placement relative to the transverse scapular ligament was variable with 50% anterior, 25% posterior, and 25% displaced (likely due to dissection). Conclusions: The results illustrate that it is possible to reliably place a needle close to the suprascapular nerve using the technique described by Barber in 2005. This study provides anatomical confirmation of Barbers description of a simple technique and the basis for clinical study.