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Suprascapular Nerve Block

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Other Names

  • Suprascapular nerve block (SSNB)
  • Suprascapular nerve blockade


Suprascapular nerve and its branches of the left shoulder[1]

Key Points

  • Typically use the linear transducer, can use curvilinear, with average depth of 3-4 cm
  • Transducer should be parallel to the spine of the scapula over suprascapular fossa or notch
  • Identify the suprascapular nerve and artery deep to supraspinatus, close to the suprascapular notch


  • First described in 1941 by Wertheim and Rovenstein[2]


  • Anatomy of the Suprascapular Nerve
    • Originates from C5, C6 nerve roots
    • Passes through the suprascapular notch which is the target of the block
    • Motor: supraspinatus, infraspinatus
    • Sensory: coracoclavicular, coracohumeral ligaments, AC joint, glenohumeral joint (posterior, superior aspects), subacromial bursa[3]
    • Suprascapular nerve supplies approximately 70% of the sensory input to the shoulder joint

Palpation vs Ultrasound Guidance

  • Palpation guided approaches have been described[4]
    • This approach is not recommended or discussed here
  • Ultrasound guided approach is recommended
    • Ultrasound guidance has shown better efficacy at 1 month with fewer complications[5]



  • None
    • Consider alternative block or analgesia on an as needed basis


Ultrasound of the suprascapular nerve.[1]
Ultrasound visualization with labels[11]
Probe position and ultrasound view labeled


  • Ultrasound
    • Can use either linear or curvilinear probe depending on preference and patient body habitus
  • Local anesthetic
  • In most patients, a 2 inch needle should be sufficient


  • Ultrasound
    • Place probe posteriorly and identify landmarks prior to starting procedure


  • Posterior approach (recommended)[12]
    • Patient is seated, ipsilateral arm at side
    • Alternatively, ipsilateral hand can rest on contralateral shoulder
    • This can be performed in lateral decubitus position or prone
  • Superior approach[13]
    • Performed with patient seated or supine
  • Transducer and Needle Position
    • Anatomical coronal oblique plane
    • Probe is parallel to the spine of the scapula, over the suprascapular fossa or notch
    • Needle approach can be medial to lateral OR lateral to medial
  • Ultrasound
    • Identify the suprascapular notch, suprascapular nerve
    • Use doppler to identify the suprascapular artery
    • Target: suprascapular notch
    • Alternative target: floor of the suprascapular fossa
    • Guide needle to target
    • Typically only need about 5 mL to achieve a complete block


  • Patient should be counseled on
    • Duration of anesthetic
    • Loss of motor function of infraspinatus and supraspinatus


  • Pneumothorax
    • Reported incidence is less than 1%[14]
    • If possible, can reposition arm to opposite shoulder to protract scapula away from chest wall
    • This can help reduce the likelihood of fenestrating the pleural cavity
  • Intravascular injection
  • Residual motor block
  • Local trauma

See Also




  1. 1.0 1.1 Chan, Chin-wern, and Philip WH Peng. "Suprascapular nerve block: a narrative review." Regional Anesthesia & Pain Medicine 36.4 (2011): 358-373.
  2. Wertheim HM, Rovenstein EA. Suprascapular nerve block. Anesthesiology. 1941;2:541Y545.
  3. Ajmani ML. The cutaneous branch of the human suprascapular nerve. J Anat. 1994;185:439Y442.
  4. Chan, Chin-wern, and Philip WH Peng. "Suprascapular nerve block: a narrative review." Regional Anesthesia & Pain Medicine 36.4 (2011): 358-373.
  5. Gorthi, Venkat, Young Lae Moon, and Jeong-Hoon Kang. "The effectiveness of ultrasonography-guided suprascapular nerve block for perishoulder pain." Orthopedics 33.4 (2010): 238-241.
  6. Tezel, Onur, et al. "A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction." The American journal of emergency medicine 32.6 (2014): 549-552.
  7. Kaya, Murtaza, et al. "Interscalene or suprascapular block in a patient with shoulder dislocation." The American journal of emergency medicine 35.1 (2017): 195-e1.
  8. Hassen, Getaw Worku, et al. "The Use of a Suprascapular Nerve Block to Facilitate the Reduction of an Anterior Shoulder Dislocation: An Alternative for Elderly Patients?." Journal of Emergency Medicine.
  9. Ozkan, Korhan, et al. “Suprascapular nerve block for the treatment of frozen shoulder.” Saudi journal of anaesthesia 6.1 (2012): 52.
  10. Jung, Tae Wan, et al. “Does combining a suprascapular nerve block with an intra-articular corticosteroid injection have an additive effect in the treatment of adhesive capsulitis? A comparison of functional outcomes after short-term and minimum 1-year follow-up.” Orthopaedic journal of sports medicine 7.7 (2019): 2325967119859277.
  11. Herring, Andrew A., Micheal B. Stone, and Arun Nagdev. "Ultrasound-guided suprascapular nerve block for shoulder reduction and adhesive capsulitis in the ED." The American journal of emergency medicine 29.8 (2011): 963-e1.
  12. Meyer-Witting M, Foster JMG. Suprascapular nerve block in the management of cancer pain. Anaesthesia. 1992;47:626.
  13. Breen TW, Haigh JD. Continuous suprascapular nerve block for analgesia of scapular fracture. Can J Anaesth. 1990;37:786Y788.
  14. Moore DC. Block of the suprascapular nerve. In: Moore DC, ed. Regional Block. 4th ed. Springfield, IL: Charles C. Thomas Co; 1979.
Created by:
John Kiel on 12 August 2022 15:55:23
Last edited:
14 April 2023 14:24:40