Interscalene and Erector Spinae Block Combination to Treat Latissimus Dorsi Repair: A Case Report

Latissimus dorsi (LD) tendon rupture is a rare injury that occurs in athletes throughout a wide range of sports, including baseball, rock climbing, tennis, and golf. LD tendon repair requires analgesia in nerve distributions from C5-T6. A 33-year-old man presented for right LD tendon repair after rock climbing eight weeks prior to the operation. An interscalene nerve block catheter was placed preoperatively for postoperative pain control. After induction of general endotracheal anesthesia, a mid-axillary incision was made down to the sixth rib and the patient underwent LD tendon repair. Postoperatively, the patient reported decreased pinprick sensation at the shoulder but pain along the mid-axillary incision. The erector spinae plane block was placed at the T3 level and pain relief was achieved within 20 minutes. This case report demonstrates that the erector spinae plane block serves as a useful adjunct to the brachial plexus block in surgeries involving the LD tendon.