Neural Modulation of Hemiparetic Shoulder Pain by Repetitive Ultrasound-Guided Suprascapularis Nerve BlockReport as inadecuate




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Background: Neuralblockade is widely used in clinical practice to alleviate acute or chronicpain, including pain during rehabilitation. Todate there is little controlled evidence to confirm the efficacy of nerveblocks in hemiparetic shoulder pain after stroke. Design: This study is a prospective,open label, cohort trial reporting result from a cohort of stroke patients affected byshoulder pain. Aim: As a cohort studyreport, in which it is often firstly reported the possibilityof an association between an observed effect and a specific environmental basedon detailed clinical evaluations and histories, we aim to firstly provide cluesin identifying Suprascapularis Nerve blockade as further valuable approach forshoulder pain after stroke. Population: Westudied a cohort of patients affected by hemiparetic shoulder pain afterStroke. Methods: Our protocol foresees nerve blocks to be performedeach 3 out of 4 days treatment lasting 30 days in conjunction with arehabilitation program with the first aim to provide the window of opportunityto proceed with effective rehabilitation. 47 potential study subjects fulfilledthe study criteria and were enrolled. Twenty-four subjects were randomised tothe study Group to receive SSNB for the pain of their hemiparetic shoulderwhile 23 subjects randomized to the controlGroup whose member did not receive SSNB. They received serial blockseach 3 out of 4 days during rehabilitation.Results: Bothtreatment reported a reduction in the intensity of their shoulder pain,according to data collected from day 1 throughday 42 6 weeks. Study Group patients, receiving SSNBs, reported significant improvementfrom entry through the whole follow-up period. The efficiency data were higherfor SSNB Group after 2 weeks and again for SSNb group at the end of treatment. Conclusion: Excellent pain relief was achieved in SSNB withoutclinically relevant complications, these patientshaving a better improvement on pain during rehabilitation, than the controlsubjects. Great efficacy has been achieved by combining a nerve block andrehabilitation. About Clinical Rehabilitation Impact, we believe thatSuprascapularis nerve blocks can help the stroke survivors maintain an ambulatoryor outpatient treatment status, maintain participation in a physical therapy orrehabilitation program, decrease the need for analgesics and in some cases lead to a complete pain relief.

KEYWORDS

Shoulder Pain; Nerve Block; Pre Emptive Analgesia; Neurological Rehabilitation; Stroke

Cite this paper

L. Di Lorenzo and S. Domenico -Neural Modulation of Hemiparetic Shoulder Pain by Repetitive Ultrasound-Guided Suprascapularis Nerve Block,- Open Journal of Anesthesiology, Vol. 3 No. 3, 2013, pp. 126-132. doi: 10.4236-ojanes.2013.33030.





Author: Luigi Di Lorenzo, Santopadre Domenico

Source: http://www.scirp.org/



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