Ultrasound-guided suprascapular and axillary nerve block for management of bilateral shoulder pain due to sickle cell vaso-occlusive crisis: A case report

This report aims to demonstrate the potential role of low-volume, ultrasound-guided targeted nerve blocks in managing refractory shoulder pain during vaso-occlusive crises (VOCs). A 24-year-old man with sickle cell disease and bilateral shoulder pain refractory to systemic analgesia underwent ultrasound-guided suprascapular nerve (SSN) blocks bilaterally and an additional right-sided axillary nerve block. The local anesthetic used was 0.2% ropivacaine (10 mL per SSN; 5 mL for the right axillary block), and the procedure was performed under standard monitoring. Pain scores on the numerical rating scale (NRS) decreased from 9/10 (right) and 7/10 (left) to 2/10 overall at 20 min post-block and to 0–1/10 at one hour. Pain relief was maintained for 24 h without supplemental opioids. This case suggests that targeted low-volume suprascapular plus axillary nerve blocks can provide safe, rapid, and opioid-sparing analgesia in selected patients with VOC involving the shoulder.