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Single versus multisite intercostal nerve block for post-thoracoscopic pain: a prospective observational study
Bixin Wen1, Jinling Yao2, Shilong Wang1
1China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Journal of Thoracic Disease
|May 22, 2025
Summary
Intercostal nerve block (ICNB) effectively reduces post-thoracoscopic pain for up to 4 days. Single-site injections provided superior short-term analgesia compared to multi-site approaches, with long-term benefits for chronic pain and quality of life.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pain Management
Background:
- The optimal extent of intercostal nerve block (ICNB) for analgesia after thoracic surgery is not well-defined.
- Evaluating ICNB efficacy and extent is crucial for managing post-thoracoscopic pain.
Purpose of the Study:
- To assess the analgesic efficacy of ICNB in adults undergoing thoracoscopic surgery.
- To determine the optimal extent of ICNB for post-thoracoscopic pain management.
Main Methods:
- A prospective observational cohort study was conducted in Beijing, China.
- Three groups were compared: ICNB single-site injection (SI), ICNB incision-specific multi-site injection (ISMSI), and non-ICNB anesthesia.
- Pain intensity (VAS) and quality of life were assessed postoperatively.
Main Results:
- The ICNB SI group showed significantly lower pain scores within 24 hours compared to the ICNB ISMSI group.
- No significant difference in pain was observed between ICNB ISMSI and non-ICNB groups within 24 hours.
- ICNB provided analgesia for up to 4 days, with reduced chronic chest pain and improved quality of life at 3 months.
Conclusions:
- Single-site ICNB injections were not inferior to multi-site injections for post-thoracoscopic analgesia.
- The single-injection approach demonstrated prolonged analgesic effects compared to multi-site injections.
- Further research is needed to understand the mechanisms behind these observed analgesic differences.
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