Case Report

"Shoulder Anterior Capsular Block: An Effective Strategy for Alleviating Pain During Shoulder Mobilisation in Adhesive Capsulitis Patients": A Case Series

Abstract

Frozen shoulder is a condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings are limited and associated with severe shoulder pain. Frozen shoulder is also referred to as adhesive capsulitis, painful stiff shoulder, and periarthritis. Treatment typically focuses on reducing shoulder pain and restoring joint mobilisation.
In the context of shoulder mobilization, the predominant nerve blocks encompass the interscalene, supraclavicular upper trunk block collectively referred to as the SCUT block, as well as the axillary nerve block. These nerve blocks demonstrate high efficacy in delivering targeted analgesia. However, a notable limitation of these interventions is the concomitant motor blockade and phrenic nerve block induced by them. This motor blockade poses a significant impediment to the initiation of early rehabilitation, thereby delaying the commencement of rehabilitative exercises and intervention.
Shoulder Anterior Capsular Block is a motor sparing block which can be effectively used in shoulder mobilisation.

[1] Wilson AT, Nicholson E, Burton L, Wild C. Analgesia for day-case shoulder surgery. Br J Anaesth. 2004; 92(3):414-5.
[2] Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J. 2016; 6(1):26-34.
[3] Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004; 51:642.
[4] Dyer BP, Rathod-Mistry T, Burton C, et al. Diabetes as a risk factor for the onset of frozen shoulder: a systematic review and meta-analysis. BMJ Open. 2023; 13:062377.
[5] Bowman CA, Jeffcoate WJ, Pattrick M, Doherty M. Bilateral adhesive capsulitis, oligoarthritis and proximal myopathy as presentation of hypothyroidism. Br J Rheumatol. 1988; 27:62.
[6] Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. MRI of the rotator interval of the shoulder. Clin Radiol. 2007; 62(5):416-23.
[7] Galluccio F, Fajardo Perez M, Yamak Altinpulluk E, Hou JD, Lin JA. Evaluation of Interfascial Plane and Pericapsular Nerve Blocks to the Shoulder Joint: A Preliminary Analysis of Shoulder Anterior Capsular Block. Pain Ther. 2021; 10(2):1741-1754.
[8] Verma D K, Neyaz O, Nanda S, Handa G. Comparison of Outcome of Ultrasound-Guided Suprascapular Nerve Block versus Intra-articular Steroid Injection in Adhesive Capsulitis of Shoulder: A Randomized Control Trial. Indian Journal of Rheumatology. 2019; 14(2): 113-118.
[9] Laumonerie P, Dalmas Y, Tibbo ME, Robert S, Faruch M, Chaynes P, et al. Sensory innervation of the human shoulder joint: the three bridges to break. J Shoulder Elbow Surg. 2020; 29(12):e499-e507.
[10] Eckmann MS, Bickelhaupt B, Fehl J, Benfield JA, Curley J, Rahimi O, et al. Cadaveric Study of the Articular Branches of the Shoulder Joint. Reg Anesth Pain Med. 2017; 42:564–70.
[11] Ramadurai R, Bhoi D, Nagarajappa A, Amar P. Pericapsular nerve group block (PENG) at neutral position for shoulder manipulation: A feasible approach for a new indication. J Clin Anesth. 2021; 75:110541.
[12] Yamak Altinpulluk E, Teles AS, Galluccio F, Simón DG, Olea MS, Salazar C, et al. Pericapsular nerve group block for postoperative shoulder pain: A cadaveric radiological evaluation. J Clin Anesth. 2020; 67:110058.
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Keywords
Suprascapular nerve Anterior approach axillary nerve Ultrasound Adhesive capsulitis Pericapsular

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How to Cite
1.
Vaidiyanathan B, Sundaresan S, Raajesh I. "Shoulder Anterior Capsular Block: An Effective Strategy for Alleviating Pain During Shoulder Mobilisation in Adhesive Capsulitis Patients": A Case Series. Arch Anesth & Crit Care. 2024;.