Mo Esfahanian, MD
Clinical Instructor, Pediatric Anesthesiology

                                                   
Your patient is an 8-year-old girl presenting with Ewing's sarcoma of the left scapula (Figure 1). She is scheduled for left chest wall wide resection, left scapula wide resection, multiple muscle transfers and muscle-skin flaps involving the shoulder and arm, along with neurolysis and vessel mobilization. The surgical team is unsure how far they will need to extend the chest wall wide resection. She has a history of severe nausea with opioids. You plan to use a regional anesthetic technique for post-operative pain control as part of your multi-modal regimen.

What is the sensory innervation of the scapula bone (i.e. osteotome)?