The shoulder block is a selective block of the nerves innervating the shoulder: suprascapular and axillary nerves. It is an alternative analgesic technique to the interscalene or supraclavicular brachial plexus blocks that avoid the motor block of the arm and hand and the phrenic nerve (hemidiaphragmatic paresis).
Indications: Analgesia of the shoulder in patients with respiratory compromise (i.e., patients who cannot tolerate >20% reduction in the forced vital capacity (FVC).
Goal: Local anesthetic injection around the suprascapular and axillary nerves (or around the lateral and posterior cords of brachial plexus caudal to the clavicle).
Needle: 5 cm (for supraclavicular approach); 5-8 cm (for suprascapular approach)
Local anesthetic volume: 5-10 mL per nerve