Escuela de Doctorado, Hospital de Manises, Universidad Católica de Valencia San Vicente Mártir, Valencia, España.
Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital de Manises, Valencia, Spain.
Pain Med. 2019 Aug 1;20(8):1547-1550. doi: 10.1093/pm/pny311.
It has been estimated that 20% of the general population will suffer shoulder pain throughout their lives, with a prevalence that can reach up to 50%. The suprascapular nerve (SSN) provides sensation for the posterior and superior regions of the glenohumeral joint, whereas the anterior and inferior zones and the skin are innervated mostly by the axillary nerve. Pulsed radiofrequency on the SSN has been proposed as a therapeutic option in chronic shoulder pain. Axillary nerve block has been proposed in the context of surgical analgesia as an adjuvant to SSN block.
Ultrasound (US)-guided techniques target the nerve selectively, minimizing patients' and physicians' exposure to harmful radiation while increasing success rates by better needle placement. We perform both US-guided techniques with the patient in a lateral decubitus position with the affected shoulder on the upper side.
The aim of this report is to describe the adaptation of a US-guided technique that targets both the suprascapular and axillary nerves for the treatment of painful shoulder syndrome. The simultaneous pulsed radiofrequency on the suprascapular and axillary nerves for the treatment of the chronic condition of shoulder pain has been scarcely studied, with very few references in the literature.
By adapting an approach developed in acute pain management, we can safely deliver pulsed radiofrequency to the suprascapular and axillary nerves for the treatment of shoulder pain.
据估计，20%的普通人群在其一生中都会遭受肩部疼痛，患病率高达 50%。肩胛上神经（SSN）为盂肱关节的后上区域提供感觉，而前下区域和皮肤主要由腋神经支配。脉冲射频治疗慢性肩部疼痛已被提出作为一种治疗选择。腋神经阻滞已被提议用于手术镇痛中，作为 SSN 阻滞的辅助手段。
超声（US）引导技术可选择性地靶向神经，使患者和医生接触有害辐射的风险最小化，同时通过更好的针置提高成功率。我们在侧卧位进行这两种超声引导技术，将受影响的肩部放在上方。
本报告旨在描述一种超声引导技术的适应性，该技术可同时靶向肩胛上神经和腋神经，用于治疗肩部疼痛综合征。对于肩部疼痛的慢性病症，同时对肩胛上神经和腋神经进行脉冲射频治疗的研究甚少，文献中仅有很少的参考文献。
通过适应急性疼痛管理中开发的方法，我们可以安全地将脉冲射频应用于肩胛上神经和腋神经，以治疗肩部疼痛。
