Regional anesthesia for scapular fracture surgery: an educational review of anatomy and techniques

Abstract

Scapular fractures are very rare, and those requiring surgical interventions are even rarer. Most scapula surgeries are done under general anesthesia with or without the regional anesthesia (RA) technique as an adjunct. Since scapular innervation is complicated, a thorough review of the relevant anatomy is warranted. In this RAPM educational article, we aimed to summarize the target nerves and blocks needed to optimize analgesia or even to provide surgical anesthesia for scapula surgeries. In this review, we are describing an algorithmic “identify-select-combine” approach, which enables the anesthesiologist to understand detailed innervation of the scapula and to obtain a procedure-specific RA technique. Procedure-specific RA would probably be the way forward for defining future RA practices.