{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:29:26Z","timestamp":1791908966303,"version":"4.3.4"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>Interscalene block, the gold standard for shoulder surgeries is inevitably associated with phrenic nerve palsy, even at low volumes. The major innervation of the shoulder joint is by suprascapular nerve and axillary nerve. Suprascapular nerve block has been used commonly for postoperative analgesia in shoulder surgeries done under GA. Combining axillary block with suprascapular nerve block was found to provide superior analgesia when compared to suprascapular block alone. Selective Suprascapular and Axillary nerve (SSAX) block provides effective analgesia in shoulder surgeries without causing diaphragm palsy, but has limited published literature. We performed ultrasound guided suprascapular block in the supraspinous fossa (posterior approach) using 10 ml of 0.25% Ropivacaine and axillary block in the quadrangular space using 6ml of 0.25% Ropivacaine before administration of general anaesthesia (GA) in 4 cases. Among four cases, 2 were closed shoulder manipulation with intra-articular steroid injection for periarthritis, 1 was closed reduction and K-wire fixation for chronic shoulder subluxation and the 4th was Latarjet procedure for recurrent shoulder dislocation. All patients received paracetamol 1g at the end of the procedure and every 6 h postoperatively. No patient experienced pain during recovery and the analgesia lasted for a mean duration of 347.5 minutes. Tramadol was required for rescue analgesia in only one patient (Latarjet surgery). We found that SSAX block provided effective analgesia in all patients, but needs randomized controlled trials with larger sample size comparing with interscalene block.<\/jats:p>","DOI":"10.4103\/sja.sja_782_21","type":"journal-article","created":{"date-parts":[[2022,9,5]],"date-time":"2022-09-05T00:18:12Z","timestamp":1662337092000},"page":"457-459","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Selective Suprascapular and Axillary nerve (SSAX) block \u2013 A diaphragm sparing regional anesthetic technique for shoulder surgeries: A case series"],"prefix":"10.4103","volume":"16","author":[{"given":"Ravi","family":"Saravanan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnamurthy","family":"Nivedita","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnamoorthy","family":"Karthik","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"key":"R1-20250925","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1093\/bja\/aen229","article-title":"Effect of local anaesthetic volume (20 vs 5 ml) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus block","volume":"101","author":"Riazi","year":"2008","journal-title":"Br J Anaesth"},{"key":"R2-20250925","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/AAP.0000000000000436","article-title":"A comparison of combined suprascapular and axillary nerve blocks to interscalene nerve block for analgesia in arthroscopic shoulder surgery: An equivalence study","volume":"41","author":"Dhir","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R3-20250925","doi-asserted-by":"crossref","first-page":"536","DOI":"10.4103\/1687-7934.198260","article-title":"Postoperative analgesia for arthroscopic shoulder surgery: Comparison between ultrasound-guided interscalene block and combined suprascapular and axillary nerve blocks","volume":"9","author":"Waleed","year":"2016","journal-title":"Ain-Shams J Anaesthesiol"},{"key":"R4-20250925","doi-asserted-by":"crossref","first-page":"296","DOI":"10.4103\/1687-7934.182272","article-title":"Shoulder block versus interscalene block for postoperative pain relief after shoulder arthroscopy","volume":"9","author":"Zanfaly","year":"2016","journal-title":"Ain-Shams J Anaesthesiol"},{"key":"R5-20250925","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/AAP.0000000000000529","article-title":"Diaphragm-sparing nerve blocks for shoulder surgery","volume":"42","author":"Tran","year":"2017","journal-title":"Reg Anesth Pain Med"},{"key":"R6-20250925","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/AAP.0000000000000573","article-title":"Anterior suprascapular nerve block versus interscalene brachial plexus block for shoulder surgery in the outpatient setting: A randomized controlled patient- and assessor-blinded trial","volume":"42","author":"Wiegel","year":"2017","journal-title":"Reg Anesth Pain Med"},{"key":"R7-20250925","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1213\/XAA.0000000000000338","article-title":"Continuous suprascapular nerve block with a perineural catheter for reverse shoulder arthroplasty rescue analgesia in a patient with severe chronic obstructive pulmonary disease","volume":"7","author":"Careskey","year":"2016","journal-title":"A A Case Rep"},{"key":"R8-20250925","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/j.arthro.2014.03.014","article-title":"Effect of ultrasonographically guided axillary nerve block combined with suprascapular nerve block in arthroscopic rotator cuff repair: A randomized controlled trial","volume":"30","author":"Lee","year":"2014","journal-title":"Arthroscopy"},{"key":"R9-20250925","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0034-7094(13)70197-1","article-title":"Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block. Comparison with interscalene block","volume":"63","author":"Pitombo","year":"2013","journal-title":"Braz J Anesthesiol"},{"key":"R10-20250925","first-page":"738","article-title":"Selective suprascapular and axillary nerve block versus interscalene plexus block for pain control after arthroscopic shoulder surgery: A noninferiority randomized parallel-controlled clinical trial","volume":"43","author":"Neuts","year":"2018","journal-title":"Reg Anesth Pain Med"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_782_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:41:13Z","timestamp":1787067673000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_782_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,3]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_782_21","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,3]]},"assertion":[{"value":"2021-11-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}