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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
The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. [1] [2] The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve.
[2] [3] It can also be used for applying a nerve block known as the rhomboid intercostal block, which can be used to relieve pain after rib fractures, and a thoracotomy. This nerve block is usually achieved by injection of the local anesthetic agent into the fascial plane between the rhomboid upper intercostal muscle and the rhombic muscles. [4 ...
Cases with persistent discomfort may be managed with an intercostal nerve blocking injection utilizing a combination of corticosteroids and local anesthetic. The condition predominantly affects women over the age of 40, though some studies have found costochondritis to still be common among adolescents presenting with chest pain. [1] [3]: 388
The primary symptom is pain and it may be localized to the distribution of one or more of the intercostal nerves, manifesting as chest and abdominal pain. [18] No treatment modality prior to neurectomy (e.g. systemic medications, cryoablation, therapeutic nerve blocks, and radioablation) has given effective pain relief and none have been curative.
The intercostobrachial nerve is the name applied to the lateral cutaneous branch of the second intercostal nerve. It arises anterior to the long thoracic nerve . It provides sensory innervation to the skin of the axilla, and a variable region of the medial side of the upper arm.
The intercostobrachial nerves (which are branches of the second and third intercostal nerves) are also frequently missed with the axillary block. Because these nerves supply sensation to the skin of the medial and posterior aspects of the arm and axilla, a tourniquet on the arm may be poorly tolerated in such cases.