Smith Neil, Liew Ziheng, Johnson Samantha, Ellard David R, Underwood Martin, Kearney Rebecca
Warwick Clinical Trials Unit, The University of Warwick, Coventry, UK.
Sandwell and West Birmingham Hospitals NHS Trust, Physiotherapy Department, West Bromwich, UK.
Br J Pain. 2021 Nov;15(4):460-473. doi: 10.1177/2049463721992091. Epub 2021 Feb 18.
Suprascapular nerve block (SSNB) injections are growing in popularity as a treatment option for people with chronic shoulder pain. The optimal method of injection and aftercare is unknown. This review describes the current methods and drugs used for performing SSNB injections in the non-surgical management of adults with chronic shoulder pain in order to inform future research in this area. Systematic searches of CINAHL, MEDLINE (OVID), AMED, Embase databases and the Cochrane Library were undertaken from inception to June 2020. Data on the method and drugs used for injection and aftercare were extracted and summarised for areas of commonality and discrepancy. We included 53 studies in this review. In total, eight different injection methods were reported within the included studies. Indirect surface land-marked methods were the most common method reported in 21 studies. Direct surface land-marked methods were reported in 12 studies. Ultrasound-guided methods used alone were reported in 16 studies. Both fluoroscopy and computed tomography methods used alone were reported in one study each. Electromyography was used in combination with other injection methods in nine studies. Wide variation in the composition of the injectate was observed between studies. Local anaesthetic was used within injectate preparations in all studies. Local anaesthetic used alone was reported in 20 studies, combined with steroid in 29 studies and combined with various other components in 5 studies. Physiotherapy following injection was reported in 26 studies. Reported details of physiotherapy varied considerably. This review identified substantial variation in the methods and drugs used to perform SSNB injection in clinical trials. Current literature demonstrates a wide range of methods used for SSNB injection administration. Consensus research defining standardised practice for SSNB injection is now needed to guide future clinical practice and research.
肩胛上神经阻滞（SSNB）注射作为慢性肩痛患者的一种治疗选择，正越来越受到欢迎。最佳的注射方法和术后护理尚不清楚。本综述描述了在非手术治疗成人慢性肩痛中进行SSNB注射所使用的当前方法和药物，以便为该领域的未来研究提供信息。从数据库创建到2020年6月，我们对CINAHL、MEDLINE（OVID）、AMED、Embase数据库和Cochrane图书馆进行了系统检索。提取并总结了关于注射和术后护理所使用的方法和药物的数据，以找出共性和差异之处。我们在本综述中纳入了53项研究。在所纳入的研究中，总共报告了八种不同的注射方法。间接体表标志法是21项研究中报告的最常见方法。12项研究报告了直接体表标志法。16项研究报告了单独使用超声引导法。荧光透视法和计算机断层扫描法单独使用的情况各在一项研究中有所报告。在九项研究中，肌电图与其他注射方法联合使用。各研究之间观察到注射剂成分存在很大差异。所有研究的注射剂制剂中均使用了局部麻醉剂。20项研究报告单独使用局部麻醉剂，29项研究报告与类固醇联合使用，5项研究报告与各种其他成分联合使用。26项研究报告了注射后进行物理治疗。所报告的物理治疗细节差异很大。本综述确定了临床试验中进行SSNB注射所使用的方法和药物存在很大差异。当前文献表明，SSNB注射给药有多种方法。现在需要进行共识研究来定义SSNB注射的标准化操作，以指导未来的临床实践和研究。
