Physical harms associated with suprascapular nerve block interventions in the non-surgical management of acute and chronic shoulder pain: A systematic review

David R Annison, Neil Smith, Emma Salt, Tim Noblet, Amar Rangan, C. McDaid
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Abstract

The utility of the suprascapular nerve block (SSNB) in the non-surgical management of shoulder pain continues to be explored, whilst its associated physical harms have not. This systematic review aims to report the physical harms associated with the SSNB in the non-surgical management of shoulder pain. A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline, Pubmed, and Scopus databases. Studies were included if they reported the presence or absence of harm following a SSNB intervention (injection, pulsed radiofrequency, ablation) in the non-surgical management of acute or chronic shoulder pain. Excluded studies were those which utilised SSNB for peri, intra, or post-surgical intervention. The McMaster tool for assessing quality of harms assessment and reporting was utilised. A total of 111 studies were included in this review of which 168 episodes of harm were reported across 4142 participants. Harm severity ranged from pneumothorax (n = 5) to local pain and bruising (n = 50). The quality of harms assessment and reporting across all studies was poor. Despite heterogeneity in SSNB intervention, and low-quality evidence, SSNB carries a low risk of physical harm. Further work is needed in addressing the poor quality of harms assessment and reporting in SSNB studies.
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肩胛上神经阻滞干预在非手术治疗急慢性肩痛中的相关物理伤害:系统性综述
肩胛上神经阻滞术(SSNB)在非手术治疗肩部疼痛方面的效用仍在不断探索之中,但其相关的身体伤害却没有被发现。本系统性综述旨在报告肩胛上神经阻滞术在肩痛非手术治疗中的相关身体危害。我们对 AMED、CINAHL、Cochrane Library、EMBASE、Medline、Pubmed 和 Scopus 数据库进行了检索。如果研究报告了在非手术治疗急性或慢性肩部疼痛的过程中,SSNB 干预(注射、脉冲射频、消融)后是否存在危害,则纳入该研究。利用 SSNB 进行围手术期、术中或术后干预的研究除外。采用麦克马斯特工具评估危害评估和报告的质量。共有 111 项研究被纳入本次综述,其中 4142 名参与者报告了 168 次伤害事件。伤害严重程度从气胸(5 例)到局部疼痛和瘀伤(50 例)不等。所有研究的伤害评估和报告质量均较差。尽管 SSNB 干预存在异质性,且证据质量较低,但 SSNB 造成身体伤害的风险较低。要解决 SSNB 研究中危害评估和报告质量不高的问题,还需要进一步努力。
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