Hello- thank you for your question. While suprascapular blocks have been described by reputable groups as providing similar analgesia as interscalene blocks (http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2678401), our experience hasn't mirrrored theirs and our interscalenes do better. That said, patients who have pulmonary contraindications are better done with suprascapular then interscalene (for example severe COPD or other lung disease requiring O2). The reason we don't ever do this is in practice is that patients with relative pulmonary contraindications that make us hesitant to do shoulder surgery with interscalene are the same patients we are hesitant to do shoulder surgery at our ASC so we turf those patients to the hospital. I hope that helps.