Townsville Hospital, Douglas, QLD, Australia.
Townsville Hospital, Douglas, QLD, Australia.
J Shoulder Elbow Surg. 2019 Mar;28(3):430-436. doi: 10.1016/j.jse.2018.11.051. Epub 2019 Jan 14.
We aimed to compare the clinical efficacy of a suprascapular nerve block (SSNB) versus subacromial injection (SA) for outpatient treatment of patients with symptomatic rotator cuff tears in a double-blinded, randomized controlled trial using sealed-envelope randomization.
A total of 42 participants with symptomatic partial- and full-thickness rotator cuff tears quantified by ultrasound or magnetic resonance imaging received either an ultrasound-guided SSNB or SA. The primary outcome measure was shoulder function measured by the modified Constant-Murley (CM) score and the secondary outcome was the pain score measured by a visual analog scale at 2, 6, and 12 weeks after injection.
We analyzed 43 shoulders (27 in male patients, 62.2%). The mean age was 65.2 years (standard deviation [SD], 11.9 years). Of the shoulders, 22 (51.2%) underwent SAs and 21 (48.8%) underwent SSNBs. Continuous variables were analyzed by an independent t test (2 tailed), and nominal data were analyzed by the Fisher exact test (1 sided). At 6 weeks, the mean change from the baseline CM score was significantly higher in the SSNB group than in the SA group (14.3 [SD, 18.1] vs 3.0 [SD, 12.8]; P = .048). At 12 weeks' follow-up, the SSNB group had a significantly higher CM score than the SA group (57.6 [SD, 10] vs 44.6 [SD, 16]; P = .023) and greater improvement from the baseline CM score (23.4 [SD, 17.5] vs 7.8 [SD, 16.5]; P = .014). At 12 weeks, the visual analog scale score was significantly better in the SSNB group than in the SA cohort (9.9 [SD, 3.3] vs 7.3 [SD, 4.3]; P = .03).
This study demonstrates that an SSNB resulted in better pain and functional results than an SA at 6 and 12 weeks for symptomatic rotator cuff tears.
我们旨在通过双盲、随机对照试验，使用密封信封随机化，比较超声引导下肩胛上神经阻滞（SSNB）与肩峰下注射（SA）治疗有症状肩袖撕裂患者的门诊疗效。
共有 42 名有症状的部分和全层肩袖撕裂患者，通过超声或磁共振成像定量，接受超声引导下 SSNB 或 SA。主要结局测量指标为改良 Constant-Murley（CM）评分评估的肩部功能，次要结局为注射后 2、6 和 12 周时视觉模拟评分（VAS）评估的疼痛评分。
我们分析了 43 个肩膀（27 个男性患者，62.2%）。平均年龄为 65.2 岁（标准差[SD]，11.9 岁）。22 个肩膀（51.2%）接受了 SA，21 个肩膀（48.8%）接受了 SSNB。连续变量采用独立 t 检验（双侧）进行分析，名义数据采用 Fisher 确切检验（单侧）进行分析。在 6 周时，SSNB 组与 SA 组相比，CM 评分从基线的平均变化显著更高（14.3[SD，18.1]比 3.0[SD，12.8]；P = .048）。在 12 周随访时，SSNB 组的 CM 评分显著高于 SA 组（57.6[SD，10]比 44.6[SD，16]；P = .023），并且从 CM 评分基线的改善程度也更高（23.4[SD，17.5]比 7.8[SD，16.5]；P = .014）。在 12 周时，SSNB 组的 VAS 评分明显优于 SA 组（9.9[SD，3.3]比 7.3[SD，4.3]；P = .03）。
这项研究表明，对于有症状的肩袖撕裂，与 SA 相比，SSNB 在 6 和 12 周时可产生更好的疼痛和功能结果。
