Regional anesthesia for scapulothoracic fixation surgery: Anatomic review and case series

Abstract

Scapulothoracic fixation surgery is a surgical intervention used for symptom relief in patients who suffer from scapular dysfunction. To date, there are few reports on the use of regional anesthesia for pain control in patients undergoing this procedure. The nerve supply of the scapula and surrounding tissues is complex and arises from both cervical and thoracic nerve roots. We suggest the use of a combined technique for perioperative pain control in patients undergoing scapulothoracic surgery. After a review of the relevant anatomy, we present four cases using combined regional techniques for postoperative pain control. The techniques utilized include thoracic paravertebral blocks with shoulder blockade, resulting in satisfactory pain control.

Selective Dorsal Scapular Nerve and Long Thoracic Nerve Blocks for Rescue Analgesia in Scapulothoracic Arthrodesis Surgery: A Case Report

“…More comprehensive brachial plexus blocks like interscalene block that covers most of the nerves have also been investigated for analgesia after STA surgery. 9,11 Results seem favorable but patient numbers are still very low, and complications may occur. Interscalene block is known for its risk of causing respiratory compromise by affecting the phrenic nerve.…”

“…Even though most of the branches are considered pure motor nerves, they also carry sensory fibers from the muscles. 9 A small number of CARE specifically targeting the DSN or LTN show reductions in pain scores. 8,10 Since our patient complained of a pain medial to his scapula, we wanted to target nerves that innervate muscles attached to the medial side of the scapula.…”