Intercostal Nerve Block

Frequently Asked Questions on Intercostal Nerve Block

What is an intercostal nerve block?

It is an injection of medication or a steroid around the intercostal nerves which are located below the ribs. It is a form of pain management that is relatively safe and easy.

Why do people get an intercostal nerve block?

The steroid reduces the swelling and inflammation in the tissue that surrounds the intercostal nerves. It may be in the ribs or in the chest wall. It can reduce pain or other symptoms that are caused by irritation or inflammation of these nerves and the structures surrounding it.

Is it painful?

The intercostal nerve block procedure involves the insertion through the skin and the tissue beneath with a needle. They are first numbed with a local anesthetic and then a thin needle is used for the injection.

What ailments would warrant this type of treatment?

Pain from Shingles or Herpes zoster are two common ailments treated with an intercostal block. If a patient experiences pain surrounding a chest scar that resulted from a surgery, an intercostal block can help reduce the pain.

How long will the procedure take?

The injection will only take a few minutes.

How is the procedure performed?

The patient is sedated and the procedure will occur in an operating room that has the use of fluoroscopy. The patient is then placed on his stomach and the area is cleaned. A local anesthetic is then given to numb the insertion area. Through the use of x-ray guidance the needle is guided to the desired nerve. Contrast can be used to make sure that the needle is placed properly. Once in place, the medication is injected.

What are the follow up procedures?

Patients should not drive or use heavy machinery for at least 24 hours after the procedure. You can apply ice at the injection site to provide comfort to the area. Patients can return to their usual activity the next day.

Are there any side effects or risks involved with the procedure?

It is a relatively safe procedure but like any other procedure, there are risks, complications, and side effects that may occur. One of the most common side effects is pain at the injection site. Patients may also experience bruising, infection, bleeding, and a collapsed lung. It is rare to experience a collapsed lung but it is possible. If the lung has collapsed the victim may feel winded or have a feeling that he can’t catch his breath. If this is the case, immediate medical attention is required.

Is there a need for further injections?

The frequency of the injections is dependent on the patient. It is possible to get additional injections if the pain goes away. If this is the case, your doctor may approve you for an additional injections. Your doctor will know whether the procedure will need to be repeated.

How do I know it will work?

Results vary per situation and per patient. There are many causes for the pain, so the results may vary depending on whether the pain is coming from this area or an area close to this area.

References:

Moore, Daniel C. (1963). INTERCOSTAL NERVE BLOCK. International Anesthesiology Clinics. 1(3):721-736,

MURPHY, DERMOT F. M.B., F.F.A.R.C.S.I. (1986). Continuous Intercostal Nerve Block. Intensive Care Unit, Royal Perth Hospital.