The trapezius plane block: Extended use in perioperative pain management in nerve transfer surgeries

Abstract

Nerve transfer surgery has emerged as a promising approach to restoring function in paralyzed muscles. The trapezius plane block (TPB) blocks the thoracic branches of the posterior primary rami, providing extended analgesia in nerve transfer surgeries. The case report describes the analgesia profiling of a young man who suffered a traumatic pan-brachial plexus injury and underwent a spinal accessory nerve to the suprascapular nerve transfer. TPB was utilized as a part of multimodal analgesia. TPB represents an advancement in regional anesthesia, providing extended analgesia and reducing opioid consumption. TPB can promote patient comfort and facilitate early mobilization.

Keywords: Fascial plane block; nerve transfer surgery; neuromonitoring; trapezius plane block.

Figure 1

Ultrasound image showing the different layers of tissue for the trapezius plane block

Figure 2

(a) Illustration showing the surgical incision for the dorsal approach for the spinal accessory to suprascapular nerve transfer with the patient in the prone position. The bony landmarks, such as the spine and scapula, have been overlapped onto the surgical image, to add perspective. (b) Image of the surgical field showing the supraspinatus ligament (SSL)

Figure 3

Image showing the trend of hemodynamics intraoperatively