Dorsal scapular and long thoracic nerves during ultrasound-guided interscalene brachial plexus block

Regional anesthesia has been widely used for intraoperative and postoperative pain management in shoulder, clavicle, and humerus surgery. Interscalene brachial plexus block (IBPB) is a common regional anesthesia method that is currently performed under ultrasound guidance. Posterior approach is more commonly used because of the risk of phrenic nerve injury from the anterior approach.1 However, the operator needs to be cautious to avoid the dorsal scapular nerve (DSN) and long thoracic nerve (LTN), during this approach.