Intercostal Nerve Blocks, Ablations, and Infusion Catheters

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İnterkostal Sinir Blokları, Ablasyonlar ve İnfüzyon Kateterler

Hector FERRALa , Samantha PARROTTEb , John ANDERSONc
aLouisiana State University Health Science Center, Department of Radiology, Division of Interventional Radiology, New Orleans, LA, USA
bLouisiana State University Health Science Center, Department of Radiology, Division of Interventional Radiology, New Orleans, LA, USA
cAugusta University Medical College of Georgia, Department of Internal Medicine, Augusta, GA, USA

Ferral H, Parrotte S, Anderson J. Intercostal nerve blocks, ablations, and infusion catheters. In: Üstünsöz B, ed. Pain Management in Interventional Radiology. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.40-3.

ABSTRACT
Intercostal nerve block (INB) is an incredibly versatile pain management technique that is typically well tolerated and safe. The wide range of indications includes rib fracture, metastatic and primary malignant disease, pre-operative, and post-operative pain management. Depending on the patient and scenario, longer-term treatment with an intercostal infusion catheter or nerve ablation can provide extended pain control. The risks of the procedure are generally low for the average patient, especially when using image guidance. Image guidance employed by an experienced user can reduce the risk for pneumothorax, which is a feared complication in patients who may already have impaired respiratory status. Both ultrasound and fluoroscopic guidance have been described for INB. Cryoablation is often performed using ultrasound with or without CT as an adjunct. This article reviews the techniques, patient selection factors, and current literature for intercostal nerve blocks and ablations.

Keywords: Intercostal nerves; nerve block; ablation techniques

ÖZET
Interkostal sinir blogu (INB), tipik olarak iyi tolere edilen ve güvenilir bir inanılmaz çok yönlü ağrı tedavi tekniğidir. Geniş yelpaze şeklinde ki endikasyonları kaburga kırıkları, metastatic ve primer malign hastalık, operasyon öncesi ve sonrası ağrı tedavilerini içermektedir. Hasta ve senaryoya bağlı olarak, sinir ablasyonu veya intercostal infuzyon kateterleriyle uzun dönem tedavi uzamış ağrı kontrolü sağlayabilir. Özellikle görüntüleme kılavuzluğu kullanıldığında, ortalama bir olgu için işlem riskleri genellikle düşüktür. Deneyimli bir kullanıcı tarafından kullanılan görütüleme kılavuzluğu, hali hazırda bozulmuş solunum durumuna sahip olguların, pnomotoraks riskini azaltabilir. İnterkostal sinir bloğu için hem ultrason ve hem de floro kılavuzlukları tanımlanmıştır. Kriyoablasyon ek olarak BT ile veya BT birlikteliği olmadan sıklıkla ultrason kullanılarak gerçekleştirilir. Bu makale teknikler, olgu seçme faktörleri ve intercostal sinir blok ve ablasyonları için olan mevcut literatüre incelemektedir.

Anahtar Kelimeler: Interkostal sinirler; sinir bloğu; ablasyon teknikleri

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