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Braz J Anesthesiol. 2013 Jan;63(1):45-51. doi: 10.1016/j.bjane.2012.04.002. Epub 2013 Aug 7.

Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block. Comparison with interscalene block.

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  • 1MD, PhD in Anesthesiology from, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), SP; Anesthesiologist Hospital Santa Izabel, Salvador, BA. Electronic address:
  • 2MD; Master of Orthopedics and Traumatology; Coordinator of the Department of Shoulder, Hospital Santa Izabel, Salvador, BA.
  • 3MD, PhD; Assistant Professor, Faculdade Baiana de Medicina, Salvador, BA.
  • 4TSA; PhD; Full Professor of Anesthesiology, Faculdade de Medicina de Botucatu, Unesp, SP.



Shoulder arthroscopic surgeries evolve with intense postoperative pain. Several analgesic techniques have been advocated. The aim of this study was to compare suprascapular and axillary nerve blocks in shoulder arthroscopy using the interscalene approach to brachial plexus blockade.


According to the technique used, sixty-eight patients were allocated into two groups: interscalene group (IG, n=34) and selective group (SG, n=34), with neurostimulation approach used for both techniques. After appropriate motor response, IG received 30 mL of 0.33% levobupivacaine in 50% enantiomeric excess with adrenalin 1:200,000. After motor response of suprascapular and axillary nerves, SG received 15 mL of the same substance on each nerve. General anesthesia was then administered. Variables assessed were time to perform the blocks, analgesia, opioid consumption, motor block, cardiovascular stability, patient satisfaction and acceptability.


Time for interscalene blockade was significantly shorter than for selective blockade. Analgesia was significantly higher in the immediate postoperative period in IG and in the late postoperative period in SG. Morphine consumption was significantly higher in the first hour in SG. Motor block was significantly lower in SG. There was no difference between groups regarding cardiocirculatory stability and patient satisfaction and acceptability. Failure occurred in IG (1) and SG (2).


Both techniques are safe, effective, and with the same degree of satisfaction and acceptability. The selective blockade of both nerves showed satisfactory analgesia, with the advantage of providing motor block restricted to the shoulder.

Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.


Anesthesia; Anesthetics; Brachial Plexus; Conduction; Local/levobupivacaine; Orthopedic Procedures; Shoulder Joint

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