• Suparna Saha, Eldor L Brish, Angus M Lowry, and Krishna Boddu.
• Department of Anesthesiology, Baylor College of Medicine, Houston, Texas, USA.
• Am J Ther. 2011 Jul 1;18(4):309-12.

AbstractShoulder pain following thoracotomy is a common postoperative complaint and can be difficult to treat. This article explores how to select patients who would benefit from a suprascapular nerve block for post-thoracotomy shoulder pain. A retrospective case review of 178 patients who underwent thoracotomy at our institution was performed. Only patients with elicitable local signs of musculoskeletal shoulder pain were offered a suprascapular nerve block with 10 cc of 0.25% bupivicaine. Of 178 patients, 92 (51.7%) complained of post-thoracotomy shoulder pain. Of these patients, 34 (37.0%) had localizing signs of musculoskeletal shoulder pain and underwent suprascapular nerve block. Twenty-nine of 34 (85.3%) patients obtained satisfactory pain relief. We estimate a true-positive rate of 85.3% with a 95% confidence interval of (68.9%, 95.0%) for those patients who received relief from suprascapular nerve block after localizing signs on physical examination of the shoulder. Patients post-thoracotomy with local signs of shoulder pain on physical examination may benefit from suprascapular nerve blocks in the immediate postoperative period.

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