Ultrasound-guided infraspinatus-teres minor plane block for acute post traumatic shoulder pain in the emergency department: A case series
For acutely painful, traumatized shoulders refractory to standard analgesia, consider the ultrasound-guided ITM block as a viable, diaphragm-sparing alternative to traditional regional blocks. If you suspect diaphragmatic compromise or need rapid analgesia to facilitate a full exam, this technique appears to offer a practical pathway. Remember that this is based on a case series, so while promising, its utility should be weighed against established protocols.
This case series details the use of an ultrasound-guided infraspinatus teres minor (ITM) inter-fascial plane block for managing severe pain following acute traumatic shoulder injuries in the emergency department. The authors highlight that standard analgesia often fails to adequately control the pain associated with these injuries, and existing regional blocks like interscalene or superior trunk blocks can be complicated by potential hemidiaphragmatic paresis. The ITM block is presented as a novel, diaphragm-sparing technique that targets the suprascapular and axillary nerves via a single approach. The report demonstrates that in their cohort of four patients, this block rapidly and effectively reduced high pain scores, allowing for prompt and thorough orthopedic evaluation without the need for rescue analgesia or sedation. Overall, the findings suggest this technique holds promise as a practical adjunct for acute shoulder trauma pain management in the ED setting.