A UK-based consensus exercise to determine the most acceptable method of suprascapular nerve block injection for people consulting with rotator cuff disorders.

Abstract

Suprascapular nerve block (SSNB) injections are used to treat shoulder pain in clinical practice. Its effectiveness compared to other shoulder pain relieving injections requires evaluation in high quality clinical trials. A range of different methods are used for SSNB injections. This study aimed to gain expert consensus on the most acceptable method of delivering SSNB injection in a future comparative clinical trial. Between October 2023 and May 2024, we conducted a three stage, online, modified Delphi survey with NHS clinicians who currently perform SSNB injections in the United Kingdom. Thirty-eight NHS registered healthcare professionals completed Stage 1, 34 completed Stage 2 and 25 completed Stage 3. Anatomical land-marked and ultrasound guided SSNB injection methods reached consensus as acceptable to use in a multi-centre clinical trial. Targeting the supraspinatus fossa (SSF) or the suprascapular notch (SSN) reached consensus as acceptable. Finally, Kenalog (40 mg) or Depo-medrone (40 mg) combined with either Bupivacaine 0.25% (5-10 ml), Bupivacaine 0.5% (5 ml to10 ml), Lidocaine 1% (5-10 ml) all reached consensus as acceptable injectates. This consensus study has provided valuable information from expert NHS clinicians to help determine the method of SSNB injection delivery in the conduct of a future clinical trial.