From Wikipedia, the free encyclopedia
Procedure for pain relief
Intercostal nerve block
(abbreviated
ICNB
) is a
nerve block
which temporarily or permanently interrupts the flow of signals along an
intercostal nerve
, usually performed to relieve
pain
.
[1]
Uses
[
edit
]
An ICNB relieves the pain associated with injured intercostal nerves. This pain can arise from chest surgery, physical trauma, aggravation of the
shingles
virus, or pressure put upon the nerves during pregnancy.
[2]
Techniques
[
edit
]
Anesthetic nerve block
[
edit
]
Injecting
local pain relievers
and
steroids
into the injured area alleviates intercostal nerve pain.
[2]
In this type of nerve block, a needle inserted between two ribs releases a steroid into the area around the nerve. The exact location of injection depends on the underlying cause of the injury. After three to five days, the steroid begins to relieve pain. Depending on the individual, the pain-relieving effects of the steroid last for days to several months.
[2]
Risks
[
edit
]
Injection without a device such as an
ultrasound
or
fluoroscope
to guide the needle can cause
pneumothorax
, a condition where air enters the cavity surrounding the lung or into a blood vessel causing local anesthetic toxicity.
[3]
Other newer facial plane blocks may be an alternative option due to a preferential safety profile
[4]
Neurolysis
[
edit
]
Physicians can also treat intercostal nerve pain by intentionally damaging the intercostal nerves. This process, known as
neurolysis
, prevents the nerves from sending pain signals.
[2]
In chemical neurolysis, a needle injects alcohol or
phenol
into the nerve and prevents the conduction of pain signals. Neurolysis can also be accomplished through a process known as
radio-frequency lesioning
.
[2]
In radio-frequency lesioning, a needle transmits radio waves to the nerve and interrupts regular pain signaling.
[5]
Additional images
[
edit
]
References
[
edit
]
- ^
Rathmell, James P. (2012).
Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine
. Lippincott Williams & Wilkins. p. 196.
ISBN
9781451154429
. Retrieved
15 September
2018
.
- ^
a
b
c
d
e
Olamikan, Sola; Gulati, Amitabh; Trescot, Andrea M. (2016), Trescot, Andrea M. (ed.),
"Intercostal Nerve Entrapment: Chest Wall"
,
Peripheral Nerve Entrapments
, Cham: Springer International Publishing, pp. 279?290,
doi
:
10.1007/978-3-319-27482-9_29
,
ISBN
978-3-319-27480-5
, retrieved
2020-09-17
- ^
"Pneumothorax - Symptoms and causes"
.
Mayo Clinic
. Retrieved
2020-09-18
.
- ^
White, L. D.; Riley, B.; Davis, K.; Thang, C.; Mitchell, A.; Abi-fares, C.; Basson, W.; Anstey, C. (2021).
"Safety of Continuous Erector Spinae Catheters in Chest Trauma: A Retrospective Cohort Study"
.
Anesthesia & Analgesia
.
133
(5): 1296?1302.
doi
:
10.1213/ANE.0000000000005730
.
hdl
:
10072/407871
.
ISSN
0003-2999
.
PMID
34473654
.
S2CID
234492181
.
- ^
"Radiofrequency neurotomy - Mayo Clinic"
.
www.mayoclinic.org
. Retrieved
2020-09-18
.
Further reading
[
edit
]
- Richard S. Weinered. (2001).
Pain Management: A Practical Guide for Clinicians, Sixth Edition
CRC Press. p. 461
ISBN
0849309263
- Lennard, TA; Vivian, DG; Walkowski, SD; Singla, AK (2011).
Pain procedures in clinical practice
(3rd ed.). Philadelphia: Elsevier/Saunders. pp. 289?92.
ISBN
978-1437737745
.
- Erdine, P. Prithvi Raj, Serdar (13 August 2012).
Pain-relieving procedures : the illustrated guide
. Chichester, West Sussex: Wiley-Blackwell. pp. 14?27.
ISBN
978-0470670385
.
{{
cite book
}}
: CS1 maint: multiple names: authors list (
link
)
- Franco, KL; Putnam JB (1998).
Advanced therapy in thoracic surgery
. Hamilton, Ont.: B.C. Decker. pp. 4?8.
ISBN
1550090445
.
- Poon, Alan.
"Intercostal nerve block"
. American Society of Regional and Pain Medicine. Archived from
the original
on 3 November 2014
. Retrieved
1 January
2014
.
- Bridenbaugh, PO; Cousins, MJ (1998).
Neural blockade in clinical anesthesia and management of pain
(3rd ed.). Philadelphia: Lippincott-Raven. pp. 457?63.
ISBN
0397511590
.
- Moore, Keith L. Moore, Anne M.R. Agur; in collaboration with and with content provided by Arthur F. Dalley II; with the expertise of medical illustrator Valerie Oxorn and the developmental assistance of Marion E. (2007).
Essential clinical anatomy
(3rd ed.). Baltimore, MD: Lippincott Williams & Wilkins. pp. 48?65.
ISBN
978-0781762748
.
{{
cite book
}}
: CS1 maint: multiple names: authors list (
link
)
- Benzon, HT; Rathmell, JP; Wu, CL; Turk, DC; Argoff CE (2008).
Raj's practical management of pain
(4th ed.). Philadelphia: Mosby-Elsevier. pp. 749?52.
ISBN
978-0323070799
.
- Ho, AM; Karmakar, MK; Critchley, LA (Aug 2011). "Acute pain management of patients with multiple fractured ribs: a focus on regional techniques".
Current Opinion in Critical Care
.
17
(4): 323?7.
doi
:
10.1097/mcc.0b013e328348bf6f
.
PMID
21716105
.
S2CID
5206646
.
- Karmakar, MK; Ho, AM (Mar 2003). "Acute pain management of patients with multiple fractured ribs".
The Journal of Trauma
.
54
(3): 615?25.
doi
:
10.1097/01.ta.0000053197.40145.62
.
PMID
12634549
.
- Waldman, Steven D. (2009).
Atlas of interventional pain management
(3rd ed.). Philadelphia, PA: Saunders/Elsevier. pp. 295?7.
ISBN
978-1416099949
.
- Moore DC, Bridenbaugh LD (1962).
"Intercostal nerve block in 4333 patients: indications, technique, and complications"
.
Anesth. Analg
.
41
: 1?11.
doi
:
10.1213/00000539-196201000-00001
.
PMID
14475639
.
- Tucker GT, Moore DC, Bridenbaugh PO, Bridenbaugh LD, Thompson GE (September 1972).
"Systemic absorption of mepivacaine in commonly used regional block procedures"
.
Anesthesiology
.
37
(3): 277?87.
doi
:
10.1097/00000542-197209000-00003
.
PMID
5051605
.
S2CID
38627773
.
- Hidalgo, NRA; Ferrante FM (2007). Finucane, BT (ed.).
Complications of regional anesthesia
(2nd ed.). New York, N.Y.: Springer. pp. 111?4.
ISBN
978-0387689043
.
- Maddox TG (October 2002).
"Adverse reactions to contrast material: recognition, prevention, and treatment"
.
Am Fam Physician
(Review).
66
(7): 1229?34.
PMID
12387435
.
External links
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]
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Types
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Techniques
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Complications
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