Correspondence  |   June 2019
Supraclav Suprascap Interscalene Shoulder Surgery: Reply
Article Information
Correspondence
Correspondence   |   June 2019
Supraclav Suprascap Interscalene Shoulder Surgery: Reply
Anesthesiology 6 2019, Vol.130, 1086-1087. doi:10.1097/ALN.0000000000002714
Anesthesiology 6 2019, Vol.130, 1086-1087. doi:10.1097/ALN.0000000000002714
We thank Dr. Ganesamoorthi et al. for their interest in our article1  and their commentary regarding our research. We would like to address each of their concerns.
First, the primary outcome revealed analgesic noninferiority of an anterior suprascapular block compared to an interscalene block for rotator cuff shoulder surgery (P = 0.012) in the postanesthesia care unit. In contrast, noninferiority was not shown when comparing supraclavicular to interscalene blocks with the same criteria (P = 0.088). The discussion in our initial publication addresses these findings at length along with our best interpretation for the collected data. Indeed, the injection endpoint for the supraclavicular group was at the superior and middle trunks. However, the exact postinjection distribution of the 15 ml of local anesthetic remains unknown. Clinical care of our patients should be based more on clinically relevant outcomes1,2  rather than conjecture of how local anesthetic anatomically flows around the brachial plexus at various points of injection.