Intercostal nerve block

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Illustration of intercostal nerve block procedure

Pronunciation
Other names
Specialty	Anesthesiology, Pain management
Uses
Complications	Pneumothorax, bleeding, infection
Approach
Types
Recovery time
Other options
Frequency

An intercostal nerve block is a medical procedure performed to alleviate pain in the chest or abdominal wall by blocking the transmission of pain signals along the intercostal nerves, which are located between the ribs. This procedure is commonly used in anesthesiology and pain management to provide temporary relief from conditions such as rib fractures, intercostal neuralgia, shingles (herpes zoster), and post-operative pain.

Procedure

The intercostal nerve block procedure involves the injection of a local anesthetic, such as lidocaine or bupivacaine, into the area around the affected intercostal nerve(s). The injection is typically guided by ultrasound or fluoroscopy to ensure precise placement of the needle and accurate delivery of the medication. The anesthetic agent works by temporarily blocking the transmission of pain signals along the intercostal nerves, thereby providing pain relief to the affected area.

Indications

Intercostal nerve blocks may be indicated for patients experiencing acute or chronic pain in the chest or abdominal wall, including:

• Rib fractures
• Intercostal neuralgia
• Postherpetic neuralgia (pain following shingles)
• Post-operative pain

Complications

As with any medical procedure, intercostal nerve blocks carry a risk of complications, including:

• Pneumothorax: Accidental puncture of the pleura (lining of the lung) may lead to pneumothorax, a condition characterized by the accumulation of air in the pleural space.
• Bleeding: There is a risk of bleeding at the injection site, particularly in patients taking anticoagulant medications.
• Infection: Although rare, infection at the injection site is a possible complication of intercostal nerve blocks.

Follow-Up

Patients who undergo intercostal nerve blocks are typically monitored for a short period following the procedure to ensure they do not develop any immediate complications, such as pneumothorax or allergic reactions to the anesthetic agent. Pain relief from the intercostal nerve block is usually temporary and may last for several hours to days, depending on the type and dosage of the medication administered.

References

Intercostal nerve block Resources
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