Suprascapular Nerve Block for Hemiplegic Shoulder Pain Post Stroke: Subgroup Analysis of Pain Response
Shanahan, Ernst Michael
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Background and Aims: Suprascapular nerve block is an effective intervention for hemiplegic shoulder pain post stroke.This study aims to ascertain baseline variables associated with significant shoulder pain reduction in a post-stroke population receiving suprascapular nerve block versus placebo. Methods: Post hoc subgroup analysis of data from a randomised controlled trial. Participants included 64 patients with hemiplegic shoulder pain (mean onset 12 weeks post stroke); 32 received suprascapular nerve block and 32 received placebo subcutaneous normal saline injection. Results: Greater rates of pain reduction were found in participants with severe baseline pain (p=0.0454) and participants aged under eighty (p=0.0417). Persons aged over eighty demonstrated poor response to intervention. Heterogeneity of sex interaction was associated with reduced placebo effect in females (p=0.036). Conclusions: Participants with severe baseline pain or aged <80 years were more likely to have reduced pain following injection. Patients >80 warrant further investigations prior to consideration of this intervention. Stroke subtype and level of spasticity were not associated with response.