Optimizing Pain Management: A Comparative Review of Regional Anesthesia Techniques for Unilateral Shoulder Surgeries

Document Type : Review article

Authors

Department of Anesthesia and Intensive Care and Pain Therapy, Faculty of Medicine, Fayoum University, Fayoum

Abstract

Postoperative pain management is a critical aspect of shoulder surgeries, necessitating effective and safe anesthesia techniques to optimize patient outcomes. This study provides a comparative analysis of regional anesthesia techniques for pain relief in unilateral shoulder surgeries, focusing on their efficacy, safety, and clinical implications. Various regional anesthesia approaches, including the interscalene block, paracoracoid subscapularis plane block, infraclavicular block, and subomohyoid block, were evaluated based on their analgesic effectiveness, duration of pain relief, and associated complications. The interscalene block remains the gold standard due to its superior pain control, but its potential for phrenic nerve palsy and respiratory complications limits its universal application. The paracoracoid subscapularis plane block has emerged as a promising alternative, offering a reliable sensory and motor blockade while minimizing adverse respiratory effects. The infraclavicular and subomohyoid blocks provide additional options, with varying degrees of efficacy and safety. Clinical studies and evidence-based practices highlight the need for a tailored approach, considering patient-specific factors, surgical requirements, and anesthetic expertise. While regional anesthesia offers significant advantages, including reduced opioid consumption, early rehabilitation, and shorter hospital stays, complications such as nerve injuries and diaphragmatic dysfunction remain concerns. Future research should explore innovative techniques, multimodal analgesia strategies, and long-term outcomes to refine regional anesthesia protocols for shoulder surgeries.

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