Efficacy of methods of intercostal nerve blockade for pain relief after thoracotomy

Ann Thorac Surg. 2005 Oct;80(4):1550-9. doi: 10.1016/j.athoracsur.2004.11.051.


Intercostal nerve blockade for postthoracotomy pain relief can be accomplished by continuous infusion of local anesthetics through a catheter in the subpleural space or through an interpleural catheter, by cryoanalgesia, and by a direct intercostal nerve block. A systematic review of randomized studies indicates that an extrapleural infusion is at least as effective as an epidural and significantly better than narcotics alone. The other techniques of intercostal blockade do not offer an advantage over narcotics alone.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anesthetics, Local / administration & dosage
  • Catheterization / methods
  • Cryotherapy / methods
  • Drug Administration Routes
  • Humans
  • Intercostal Nerves*
  • Nerve Block / methods*
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / therapy*
  • Pleura
  • Thoracotomy / adverse effects*
  • Treatment Outcome


  • Anesthetics, Local