Regional anesthesia for scapular surgeries: a scoping review

Scapular or shoulder blade surgeries are uncommon in routine anesthesia practice. Most undisplaced injuries are managed conservatively; therefore, the literature on appropriate anesthetic management plans for scapular surgeries is sparse. This bone is well-protected by the surrounding muscles and tissues, and any surgery is associated with significant tissue exploration and excessive postoperative pain. The complicated innervation of the structures surrounding this bone makes pain management extremely challenging. However, recent advances in ultrasound-guided nerve blocks and cadaveric studies have been helpful in identifying target nerves to provide analgesia or even surgical anesthesia, if planned carefully. Literature searches in PubMed, Embase, and Google Scholar resulted in only a handful of articles, mainly case reports and series, in addition to being inaccessible because of the need for subscription charges. We aimed to gather as much information as possible to cover all possible regional blocks that can be performed for scapular surgeries and compile them concisely in a single article.