Intercostal Nerve Block

Please tell Dr. Moradian/Dr. Vartanian if you have any allergy, particularly to iodine. If not receiving sedation, patients can eat a light meal a few hours before the procedure. If a patient is an insulin dependent diabetic and receiving sedation, they may need to change their morning dose of insulin to account for not eating the morning of the procedure. Patients may take their routine medications (i.e., high blood pressure and diabetic medications, e.g. Glucophage).

Patients should continue to take pain medications or anti-inflammatory medications the day of their procedure. If a patient is on Coumadin or another blood thinner, they must notify Dr. Moradian/Dr. Vartanian so an appropriate plan can be made for stopping the medication before the procedure. A driver should accompany the patient and be responsible for getting them home.

The patient is placed on the procedure table on their stomach so the physician can best visualize the lower margin of the ribs where the intercostal nerves pass, using x-ray guidance. The skin is scrubbed using antibacterial soap. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds.

After the numbing medicine has been given time to be effective, the physician directs a very small needle using x-ray guidance near the intercostal nerve. Then, a small amount of numbing medicine (local anesthetic) and sometimes an anti-inflammatory (steroid) is injected.

After the procedure, the patient is taken to the recovery room. An x-ray of the chest will also be ordered to make sure that the procedure has not cause a small deflation of the lungs (pneumothorax). Patients are then asked to report the percentage of pain relief. Patients may return to their normal activities on the day of the procedure.