Poststernotomy neuralgia: a new pain syndrome

Anesth Analg. 1989 Jul;69(1):81-2.

Abstract

Fifty-four patients developed severe intercostal neuralgia a few weeks after sternotomy. Immediate relief afforded by parasternal nerve blocks confirmed that the pain derived from scar-entrapped neuromas of the anterior rami of the first 4-6 intercostal nerves in the upper (and mainly left) interchondral spaces after insertion of the sternal wires. Permanent relief (i.e., over 6 months) followed repeated bupivacaine blocks in 57.4% of the patients, phenol blocks in another 22.2%, and alcohol blocks in a remaining 9%. Treatment was successful in 87% of the patients.

MeSH terms

  • Adult
  • Aged
  • Bupivacaine
  • Cicatrix / complications
  • Ethanol
  • Humans
  • Intercostal Nerves / drug effects
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Neuralgia / etiology*
  • Neuralgia / therapy
  • Pain, Postoperative / therapy*
  • Phenol
  • Phenols
  • Sternum / surgery*

Substances

  • Phenols
  • Phenol
  • Ethanol
  • Bupivacaine