Intercostal nerve block for lumpectomy: superior postoperative pain relief with bupivacaine.
Illustration of the 4th
intercostal nerve to the breast
Intrapleural
intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection.
Currently, surgeons use epidurals,
intercostal nerve blocks and prescription narcotics for pain management.
14] In a cadaveric and electrophysiological study, Fahim and colleagues showed that the most significant
intercostal nerve contributions to the anterolateral wall came from the T11 and T12 nerves.
The
intercostal nerve block is indicated for use in surgical procedures performed on the thorax and upper abdomen.
Nerve blocks: Intrathecal/subarachnoid injections; Epidural injections for pain; Celiac plexus nerve blocks; Continuous epidural analgesia; Facet Joint Injections/Median Branch Nerve Blocks;
Intercostal nerve blocks; Paravertebral Nerve Blocks; Percutaneous alcohol injections for the ablation of intractable pain; Transforaminal epidural injections; Anesthesiology Notes.
Objective: To assess the efficacy of
intercostal nerve protection by intercostal muscle (ICM) flap in postthoracotomy pain improvement compared to intracostal suturing.
Khurram et al24 used injections and
intercostal nerve blocks with placebo which is not very kind to the chronic sufferers of pain.
21) described the ultrasound-guided stellate ganglion block in 1995, while the
intercostal nerve block technique was described in 2004 by Eichenberger et al.
In transverse section the PVS is triangular and contains the
intercostal nerve, its dorsal primary ramus and the rami communicantes, the sympathetic chain, the intercostal artery and veins as well as fibrous fatty matter.
It could be seen clearly that the tip of the 7th rib dislocated from the 8th rib and that the 7th
intercostal nerve was being pinched in between (Fig.