Suprascapular nerve block for analgesia in traumatic scapular fractures performed by emergency physicians: A case series

Abstract

Scapular fractures, typically resulting from high-energy trauma, cause severe pain that restricts shoulder girdle movement and delays rehabilitation. Adequate analgesia is essential to facilitate physiotherapy and improve recovery, yet optimal techniques remain underutilized in the Emergency Department (ED). Suprascapular nerve block may offer an effective solution to this challenge.

We report a series of ten adult patients with traumatic scapular fractures who presented to the ED with severe pain (Defense and Veterans Pain Rating Scale ≥7) and a mean Injury Severity Score (ISS) of 30. All patients underwent ultrasound-guided suprascapular nerve block performed by trained ED physicians using point-of-care ultrasound. Pain scores were recorded at baseline, 30 min, 60 min, and 2 h after the block, and adverse events were monitored for two hours.

The mean baseline pain score was 8.9 ± 0.7, which reduced to 2.9 ± 0.9 at 30 min, 1.5 ± 0.97 at 60 min, and 1.1 ± 0.3 at two hours post-procedure (p < 0.001). All ten patients achieved at least a 50 % reduction in pain within 30 min. Complications such as pneumothorax, vascular puncture, or local anesthetic toxicity were not observed. All patients were able to move their shoulders without pain within an hour of the block.

Ultrasound-guided suprascapular nerve block is a rapid, safe, and highly effective analgesic intervention for traumatic scapular fractures in the ED. In the future, a randomized controlled trial should be performed to prove the efficacy of the suprascapular nerve block in providing analgesia for traumatic scapular fractures.