Incidence of pneumothorax from intercostal nerve block for analgesia in rib fractures.
BACKGROUND
The incidence of pneumothorax (PTX) after individual intercostal nerve block (INB) for postoperative pain reportedly varies from 0.073% to 19%.1-3 This study investigated the incidence of PTX after INB for rib fractures.


METHODS
We conducted a retrospective chart review of patients admitted between January 1996 and December 1999 with rib fractures who received INB.


RESULTS
One hundred sixty-one patients received 249 intercostal nerve block procedures (INBPs). An INBP is one session where a set of intercostal nerves are blocked. A total of 1,020 individual intercostal nerves were blocked. There were 14 pneumothoraces. The overall incidence of PTX per patient was 8.7%, with an incidence of PTX per INBP of 5.6%. The incidence of PTX was 1.4% for each individual intercostal nerve blocked.


CONCLUSIONS
The incidence of PTX per individual intercostal nerve blocked is low. INB is an effective form of analgesia, and for most patients with rib fractures one INBP is sufficient to allow adequate respiratory exercises and discharge from the hospital.
Shanti
C M
CM
Department of Surgery, The Detroit Medical Center/Wayne State University, 4201 St. Antoine, Detroit, MI 48201, USA.
Carlin
A M
AM
Tyburski
J G
JG
D000698:Analgesia; D005260:Female; D006801:Humans; D015994:Incidence; D007367:Intercostal Nerves; D008297:Male; D008499:Medical Records; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012253:Rib Fractures