1,010 results match your criteria neurectomy intercostal

Abdominal flank bulge following intercostal neurectomy for symptomatic rib fracture nonunion.

BMJ Case Rep 2021 Jun 11;14(6). Epub 2021 Jun 11.

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, Zuid-Holland, The Netherlands.

The gold standard for rib fracture nonunion management remains a matter of debate. Operative treatment of rib fracture nonunion has become increasingly popular. A 69-year-old man was operatively treated with intercostal neurectomy of the left eighth rib to resolve chronic thoracic pain following a rib fracture nonunion. Read More

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Serratus Anterior Plane Block Combined with General Analgesia and Patient-Controlled Serratus Anterior Plane Block in Patients with Breast Cancer: A Randomized Control Trial.

Adv Ther 2021 06 22;38(6):3444-3454. Epub 2021 May 22.

Department of Anesthesiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, No.1 Panfu Road, Yuexiu District, Guangzhou, 510180, Guangdong, China.

Introduction: Anterior serratus muscle plane block is a novel regional block technique for blockade of the sensory plane of the lateral cutaneous branch of the intercostal nerve (T2-T9), which effectively relieves the pain of patients and improves the quality of recovery. This study aimed to observe the early effectiveness and safety of serratus anterior plane block combined with general anesthesia and patient-controlled serratus anterior plane block in early postoperative recovery in breast cancer.

Methods: The study involved a total of 84 patients undergoing radical mastectomy in our hospital. Read More

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High-risk surgeries, anesthetic challenges, and real benefits of peripheral regional techniques revisited.

Niger J Clin Pract 2021 May;24(5):782-785

Department of Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.

Patients with high-risk conditions for surgery may benefit from some form of regional block when neuroaxial regional blocks may be life threatening. Despite the increased use of ultrasound-guided peripheral regional blocks internationally, local infiltration and targeted nerve blocks aided by knowledge of anatomical landmarks remain helpful in these two patients presented. A 48-year old woman, presented with bleeding left breast mass, mild respiratory distress, and radiological features of lung metastases (Carcinoma of the breast stage 4). Read More

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Ultrasound-Guided Regional Anesthesia-Current Strategies for Enhanced Recovery after Cardiac Surgery.

Medicina (Kaunas) 2021 Mar 25;57(4). Epub 2021 Mar 25.

1st Department of Cardiovascular Anesthesiology and Intensive Care, "Prof. C. C. Iliescu" Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, Romania.

With the advent of fast-track pathways after cardiac surgery, there has been a renewed interest in regional anesthesia due to its opioid-sparing effect. This paradigm shift, looking to improve resource allocation efficiency and hasten postoperative extubation and mobilization, has been pursued by nearly every specialty area in surgery. Safety concerns regarding the use of classical neuraxial techniques in anticoagulated patients have tempered the application of regional anesthesia in cardiac surgery. Read More

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Surgical Management of Abdominal Anterior Cutaneous Nerve Entrapment Syndrome: Case Report, Surgical Technique, and Literature Review.

Plast Reconstr Surg Glob Open 2021 Mar 26;9(3):e3453. Epub 2021 Mar 26.

Section of Plastic Surgery, University of Calgary, Calgary, Alberta, Canada.

Abdominal anterior cutaneous nerve entrapment syndrome (ACNES) is an emerging diagnosis, with estimated incidence of 13%-30% of the adult population. It is a syndrome characterized by chronic abdominal pain caused by entrapment of cutaneous branches of thoracoabdominal nerves at the lateral border of the rectus abdominis muscle. If conservative treatment with pain medication, botulinum toxin, or lidocaine injections is inadequate, surgical management is indicated. Read More

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Anesthetic effect of ultrasound-guided multiple-nerve blockade in modified radical mastectomy in patients with breast cancer.

Medicine (Baltimore) 2021 Feb;100(7):e24786

Department of Anesthesiology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, No. 166 West Yulong Road, Yancheng, P. R. China.

Introduction: Routine anesthesia modality for modified radical mastectomy (MRM) includes general anesthesia (GA), epidural blockade-combined GA and nerve blockade-combined GA. However, GA has been associated with postoperative adverse effects such as vertigo, postoperative nausea and vomiting and requirement for postoperative analgesia, which hinders recovery and prognosis. Moreover, combined blockade of thoracic paravertebral nerves or intercostal nerves and adjuvant basic sedation for massive lumpectomy provided perfect anesthesia and reduced opioid consumption, whereas the excision coverage did not attain the target of MRM. Read More

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February 2021

A narrative review of ultrasound-guided serratus anterior plane block.

Ann Palliat Med 2021 Jan 31;10(1):700-706. Epub 2020 Dec 31.

Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China. Email:

Ultrasound-guided serratus anterior plane block (SAPB) is located using ultrasound at the level of the midaxillary line and the fifth rib, and a certain amount of local anesthetics is injected either superficially or deeply into the serratus anterior muscle, blocking the third to sixth intercostal nerves, the long thoracic and thoracodorsal nerves. It is mainly used in breast surgeries, rib fractures and thoracotomy to manage the pain of the anterolateral chest wall. The surgery of anterolateral chest wall is often accompanied by severe postoperative pain, leading to postoperative infection, atelectasis and other complications, and prolonged hospitalization. Read More

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January 2021

Treatment and Management of Twelfth Rib Syndrome: A Best Practices Comprehensive Review.

Pain Physician 2021 01;24(1):E45-E50

Department of Anesthesiology, LSUHSC School of Medicine, Shreveport, LA; Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE; Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Pain Consultants-Envision Physician Services, Phoenix, AZ.

Background: Twelfth rib syndrome, or slipping of the 12th rib, is an often overlooked cause for chronic chest, back, flank, and abdominal pain from irritation of the 12th intercostal nerve. Diagnosis is clinical and follows the exclusion of other causes of pain. This syndrome is usually accompanied by long-suffering, consequent psychiatric comorbidities, and increased health care costs, which are secondary to the delayed diagnosis. Read More

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January 2021

Anatomical basis of erector spinae plane block: a dissection and histotopographic pilot study.

J Anesth 2021 02 19;35(1):102-111. Epub 2020 Dec 19.

Department of Neurosciences, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy.

Purpose: Erector spinae plane (ESP) block is an interfascial blockade used in different clinical scenarios. This study investigated the ventral extent of dye diffusion in ESP block.

Methods: The ultrasound-guided ESP block was bilaterally performed with an injection at the T5 vertebral level (21-Gauge, 50 mm needle), using diluted black tissue marking dye (20 mL; 1:4 ratio with standard saline solution) instead of local anesthetic on two fresh-frozen corpses within the body donation program of the University of Padova. Read More

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February 2021

Avoiding the Internal Mammary Artery During Parasternal Blocks: Ultrasound Identification and Technique Considerations.

J Cardiothorac Vasc Anesth 2021 Jun 16;35(6):1594-1602. Epub 2020 Nov 16.

Department of Anesthesia and Cardiac Surgery Intensive Care Unit, San Michele Hospital, Maddaloni, Caserta, Italy.

Fascial plane chest wall blocks are an integral component to optimal multimodal postoperative analgesia in breast and cardiothoracic surgery, facilitating faster functional recovery and earlier discharge. Pectoral nerves block and serratus plane block have been used to treat postsurgical pain after breast and cardiothoracic surgeries; however, they cannot be used to anesthetize the anterior chest wall. Ultrasound parasternal block, or pectointercostal fascial block and transversus thoracis muscle plane block are two novel ultrasound-guided anesthetic and analgesic techniques that block the anterior cutaneous branches T2 to T6 intercostal nerves, providing anesthesia and analgesia to the anterior chest wall. Read More

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Serratus anterior plane block versus intercostal nerve block for postoperative analgesic effect after video-assisted thoracoscopic lobectomy: A randomized prospective study.

Medicine (Baltimore) 2020 Dec;99(49):e22102

Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: Serratus anterior plane block (SAPB) and intercostal nerve block (ICNB) are attractive options for multimodal analgesia in patients undergoing thoracoscopic surgery, but which block is superior remains unclear.

Objective: The present study aimed to assess the effect of SAPB versus ICNB on reducing postoperative pain after video-assisted thoracoscopic surgery (VATS) for lobectomy.

Methods: This prospective, randomized, active-intervention-controlled, subject-assessor-blinded, single-center, parallel-group trial allocated 18- to 80-year-old patients with American Society of Anesthesiologists status I to III to receive either SAPB or ICNB in a 1:1 ratio. Read More

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December 2020

The effect of anaesthesia on flank incisional pain: infiltration versus intercostal nerve block, a comparative study.

Pan Afr Med J 2020 27;36:356. Epub 2020 Aug 27.

Anaesthesia Department, King Hussein Medical Centre, Amman, Jordan.

The object of this study is to determine which local wound analgesic option is superior, local anaesthetic infiltration or intercostal nerve block, by combined local anaesthetic agents (0.5% bupivacaine + 2% lidocaine) and to detect which option can best alleviate the post-operative pain management and significantly prolong the time to the first rescue analgesic requirement and the total consumption of opioids in the first post-operative 72 hrs. The medical records of 1458 patients who underwent flank incision procedures by two different surgeons in our institute were retrospectively reviewed. Read More

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January 2021

Moving Toward Opioid-Free Breast Surgery: Regional Blocks and a Novel Technique.

Clin Plast Surg 2021 Jan 3;48(1):123-130. Epub 2020 Nov 3.

Plastic & Reconstructive Surgery, University of Chicago Medicine, Chicago, IL, USA; Iteld Plastic Surgery, 939 West North Avenue, Suite 600, Chicago, IL 606042, USA. Electronic address:

Perioperative pain control is of increasing importance as awareness regarding the risks of under-controlled pain and opioid abuse rise. Enhanced recovery protocols and multimodal analgesia, including regional blocks, are useful tools for the plastic surgeon. The thoracic paravertebral block, pectoralis nerve I and pectoralis nerve II blocks, and proximal intercostal blocks are 3 described methods that provide regional anesthesia for breast surgery. Read More

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January 2021

Transversus abdominis plane block: A new method in renal colic pain management.

Am J Emerg Med 2020 10 11;38(10):2116-2118. Epub 2020 Jul 11.

University of Kutahya Health Sciences, Medical Scholl, Department of Emergency Medicine, Kutahya, Turkey. Electronic address:

In recent decades, regional plane blocks via ultrasonography have become very popular in regional anesthesia and are more commonly used in pain management. The transversus abdominis plane (TAP) block is a procedure where local anesthetics are applied to block the anterior divisions of the tenth thoracic intercostal through the first lumbar nerves (T10-L1) into the anatomic space formed amidst the internal oblique and transversus abdominis muscles located in the antero-lateral part of the abdomen wall. The most important advantage of this block method is that ultrasonographic identification is easier and its complications are fewer compared with central neuroaxial or paravertebral blocks. Read More

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October 2020

Erector spinae plane block: A narrative review with systematic analysis of the evidence pertaining to clinical indications and alternative truncal blocks.

J Clin Anesth 2021 Feb 5;68:110063. Epub 2020 Oct 5.

St. Mary's Hospital, Department of Anesthesiology, McGill University, 3830 Ave Lacombe, Montreal H3T-1M5, Quebec, Canada. Electronic address:

Study Objective: This narrative review discusses the anatomy, mechanism of action, techniques, pharmacology, indications, complications and substitutes for erector spinae plane (ESP) blocks.

Interventions: The Medline, Embase and Google Scholar databases (inception-last week of April 2020) were searched. For indications and alternative blocks, a systematic analysis of the available evidence was carried out. Read More

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February 2021

Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis.

PLoS One 2020 5;15(10):e0237363. Epub 2020 Oct 5.

Department of Anesthesiology, The Second Hospital of Nanjing, Nanjing, Jangsu, China.

Objective: To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery.

Methods: The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. Read More

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November 2020

The Analgesic Efficacy of Pecto-Intercostal Fascial Block Combined with Pectoral Nerve Block in Modified Radical Mastectomy: A Prospective Randomized Trial.

Pain Physician 2020 09;23(5):485-493

Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt.

Background: Pectoral nerve (Pecs) block is one of the most promising regional analgesic techniques for breast surgery. However, Pecs II block may not provide analgesia of the medial aspect of the breast or the entire nipple-areolar complex.

Objectives: The aim of the present study was to investigate the efficacy of combining the pecto-intercostal fascial block (PIFB) and Pecs II block for perioperative analgesia following modified radical mastectomy (MRM). Read More

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September 2020

Erector spinae plane block versus retrolaminar block for postoperative analgesia after breast surgery: a randomized controlled trial.

J Anesth 2021 02 11;35(1):27-34. Epub 2020 Sep 11.

Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.

Purpose: The newly introduced erector spinae plane block (ESPB) has given anesthesiologists an alternative regional anesthetic technique for thoracic analgesia. Although ESPB and retrolaminar block (RLB) have similar puncture sites, no clinical study comparing ESPB and RLB has been reported. The aim of this study was to compare ESPB and RLB in terms of analgesic efficacy in the context of multimodal analgesia following breast surgery. Read More

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February 2021

[Application of thoracoscopy-guided thoracic paravertebral block for analgesia after single-port video-assisted pulmonary lobectomy].

Zhonghua Yi Xue Za Zhi 2020 Sep;100(33):2596-2600

Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China.

To investigate the effects of thoracoscopy-guided thoracic paravertebral block for analgesia after single-port video-assisted pulmonary lobectomy. From December 2019 to April 2020, 60 patients receiving single-port video-assisted pulmonary lobectomy at Ningbo Medical Center Lihuili Hospital were selected. The patients were randomly and equally divided into control group and paravertebral block group using a random number table. Read More

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September 2020

The Treatment of Rib Fractures : A Single-Center Comparison.

Am Surg 2020 Sep 26;86(9):1144-1147. Epub 2020 Aug 26.

Division of Trauma & Acute Care Surgery, Department of Surgery, University of South Alabama College of Medicine, Mobile, AL, USA.

Background: Rib fractures are a major problem characterized by pain, increased length of stay, and respiratory complications. Treatments include fixation, management with opiates, paraspinous local anesthetic pumps, and intercostal nerve blocks. The aim of this study was to evaluate the use of treatment options and compare clinically relevant outcomes. Read More

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September 2020

Ultrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain Management in Cardiac Surgery: A Prospective, Randomized, Placebo-Controlled Trial.

J Cardiothorac Vasc Anesth 2021 Mar 24;35(3):896-903. Epub 2020 Jul 24.

Center for Anesthesia and Research Excellence, Department of Anesthesia Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA. Electronic address:

Objective: To explore the effect of pecto-intercostal fascial plane block (PIFB) on postoperative opioid requirements, pain scores, lengths of intensive care unit and hospital stays and incidence of postoperative delirium in cardiac surgical patients.

Design: Single- center, prospective, randomized (1:1), quadruple- blinded, placebo-controlled trial.

Setting: Single center, tertiary- care center. Read More

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[Thoracoscopic Sympathectomy for Palmar and Axillary Hyperhidrosis].

Zentralbl Chir 2020 Oct 23;145(5):421-424. Epub 2020 Jul 23.

Klinik für Kinderchirurgie, Universitätsklinikum Mainz, Deutschland.

Objective: This video is a step-by-step description of thoracoscopic sympathectomy.

Indication: Sweating is essential for thermoregulation. Hyperhidrosis is a condition of excess sweating from the eccrine glands and is associated with severe suffering for patients of all ages. Read More

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October 2020

Anatomical Evaluation of a Conventional Pectoralis II Versus a Subserratus Plane Block for Breast Surgery.

Anesth Analg 2020 09;131(3):928-934

Department of Anatomy, Foresterhill, University of Aberdeen, Aberdeen, Scotland, United Kingdom.

Background: Pectoralis I and II (Pecs I/Pecs II) blocks are modern regional anesthetic techniques performed in combination to anesthetize the nerves involved in breast surgery and axillary node dissection. Pecs II spread and clinical efficacy is thought to be independent of whether injection occurs between pectoralis minor and serratus anterior or deep to serratus anterior. Injecting deep to serratus anterior onto the rib may be technically easier; however, our clinical experience suggests that this approach may be less effective for axillary dissection. Read More

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September 2020

A pilot randomized-controlled trial evaluating the erector spinae plane block in thoracic and breast surgery.

Can J Anaesth 2020 Oct 21;67(10):1371-1380. Epub 2020 Jul 21.

Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Victoria Parade, Fitzroy, PO Box 2900, Melbourne, VIC, 3065, Australia.

Purpose: This pilot study evaluated the feasibility of investigating the effect of the erector spinae plane (ESP) block on the patient-centred outcomes of quality of recovery-15 (QoR-15), and brief pain inventory (BPI) in thoracic and breast surgery patients.

Methods: In this randomized-controlled pilot trial, 82 patients undergoing video-assisted thoracoscopic surgery (n = 77) and mastectomy (n = 5) received either continuous ESP block with ropivacaine (ropivacaine group) or the same procedure with 0.9% saline (saline group). Read More

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October 2020

Is ultrasound-guided thoracic paravertebral nerve block better than intercostal nerve block for video-assisted thoracic surgery under spontaneous-ventilating anesthesia?

Rev Assoc Med Bras (1992) 2020 May 3;66(5):568. Epub 2020 Jul 3.

Department of Immunology, Nanjing medical university, Jiangsu, Nanjing, China.

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Intraoperative Intercostal Nerve Block for Postoperative Pain Control in Pre-Pectoral versus Subpectoral Direct-to-Implant Breast Reconstruction: A Retrospective Study.

Medicina (Kaunas) 2020 Jun 30;56(7). Epub 2020 Jun 30.

Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Korea.

Patients undergoing mastectomy and implant-based breast reconstruction have significant acute postsurgical pain. The purpose of this study was to examine the efficacy of intercostal nerve blocks (ICNBs) for reducing pain after direct-to-implant (DTI) breast reconstruction. Between January 2019 and March 2020, patients who underwent immediate DTI breast reconstruction were included in this study. Read More

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Transmuscular quadratus lumborum (TQL) block for laparoscopic colorectal surgery: study protocol for a double-blind, prospective randomized placebo-controlled trial.

Trials 2020 Jun 26;21(1):581. Epub 2020 Jun 26.

Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.

Background: Thoracic epidural anesthesia is no longer considered the gold standard for perioperative analgesia in laparoscopic colorectal procedures. In the search for alternatives, the efficacy of the transverse abdominal plane (TAP) block and other abdominal wall blocks such as the transmuscular quadratus lumborum (TQL) block continues to be investigated for postoperative pain management. Most of the initial studies on TAP blocks reported positive effects; however, the amount of studies with negative outcomes is increasing, most probably due to the fact that the majority of abdominal wall blocks fail to mitigate visceral pain. Read More

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Comparison of preincisional and postincisional parasternal intercostal block on postoperative pain in cardiac surgery.

J Card Surg 2020 Jul 24;35(7):1525-1530. Epub 2020 Jun 24.

Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Background: The optimum cardiac surgical pain management has known to maintain hemodynamic stability and, reduces respiratory and cardiovascular complications. Postoperative parasternal intercostal block has shown to reduce postoperative analgesic consumption after cardiac surgery. Therefore, this study sought to investigate the effectiveness of the preoperative ultrasound guided parasternal block in reducing postoperative pain after cardiac surgery. Read More

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Comparison of the effect of ultrasound-guided thoracic paravertebral nerve block and intercostal nerve block for video-assisted thoracic surgery under spontaneous-ventilating anesthesia.

Rev Assoc Med Bras (1992) 2020 Apr;66(4):452-457

. Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212002, China.

Objective: The aim of the current study was to compare the efficacy of two different techniques for blocking chest nerves during video-assisted thoracic surgery (VATS) under spontaneous-ventilating anesthesia.

Methods: One hundred patients were recruited in this study and divided into two groups. The first, P group, underwent the TPVB approach; the second, I group, underwent the ICNB approach. Read More

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