Feasibility of Ultrasound-Guided Suprascapular Nerve Block in Improving Shoulder Motion and Pain Post-Surgery in Breast Cancer Survivors: A Randomized Control Trial

Laxmi Prajapati; Anil Kumar Gupta; Dileep Kumar; Pooja Ramakant; Sudhir R Mishra; Ganesh Yadav; Anjana G; K Deepak

doi:10.1007/s13193-024-02024-7

Feasibility of Ultrasound-Guided Suprascapular Nerve Block in Improving Shoulder Motion and Pain Post-Surgery in Breast Cancer Survivors: A Randomized Control Trial

Indian J Surg Oncol. 2024 Dec;15(4):955-962. doi: 10.1007/s13193-024-02024-7. Epub 2024 Jul 9.

Authors

Laxmi Prajapati¹, Anil Kumar Gupta¹, Dileep Kumar¹, Pooja Ramakant², Sudhir R Mishra¹, Ganesh Yadav¹, Anjana G¹, K Deepak¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, King George's Medical University, Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003 India.
² Dept. of Endocrine Surgery, King George's Medical University, 7Th Floor, Shatabdi Phase II , Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003 India.

PMID: 39555335
PMCID: PMC11564450 (available on 2025-12-01)
DOI: 10.1007/s13193-024-02024-7

Abstract

Patients with locally advanced breast cancer post-mastectomy complain of shoulder pain and restricted shoulder movement. The role of suprascapular nerve block (SSNB) in such patients needs to be explained as it may help in improving their quality of life along with pain relief. This study aims to evaluate the effect of ultrasound-guided suprascapular nerve block (SSNB) in improving shoulder motion and pain following surgery and compare its effect with exercise group. This study is a randomized controlled trial. Forty-eight patients were enrolled in the study who were referred from the endocrine surgery department, and they were randomized into two groups. Group A underwent ultrasound-guided (USG-guided) SSNB and Group B underwent an exercise program only. Each group had 24 patients who complained of pain and restricted shoulder range of motion (ROM). The outcome measures were assessed using the Mann-Whitney test for visual analog score and unpaired t-test for shoulder ROM and Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) questionnaire score. All patients (n = 48) had modified radical mastectomy. The mean age was 44 ± 9.44 years and all were female gender. The improvement was noted in both the groups, but in intergroup comparison, Group A patients had significant improvement in VAS, Q-DASH score, shoulder flexion, and abduction immediately and at the 4th week follow-up (p = 0.001). No adverse effect was reported. A small sample size and no blinding reduce the strength of the study. USG-guided SSNB in post-mastectomy patients is proven to be an effective, safe, and economically accepted treatment for low-resource countries like India.

Keywords: Ca breast; DASH score; SSNB; Shoulder ROM; VAS.

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