ABSTRACT
Intercostal nerve blocks can be performed prior to surgery or intra-operatively, either during or after thoracotomy. A minimum of 2 adjacent intercostal spaces both cranial and caudal to the incision or injury site must be blocked due to overlapping nerve supply. The needle is introduced percutaneously, using aseptic technique, at the caudal border of the rib near the level of the intervertebral foramen (Figure 3-9). The needle should penetrate skin, subcutaneous tissue, and then intercostal muscles before the appropriate volume of local anesthetic is deposited. Post-thoracotomy pain is generally controlled for 3 to 6 hours following successful block.
