Intercostal nerve protection to prevent post-thoracotomy pain

Posterolateral thoracotomy is a commonly used surgical approach to access thoracic structures for non-cardiac surgery. This incision involves transection of major muscles and retraction of ribs against resistance. In spite of “effective” postoperative analgesic measures including epidural analgesia or patient controlled analgesia, many patients have considerable acute and chronic postoperative pain which may lead to increased post-operative complications, especially pulmonary complications, increased consumption of analgesics, prolonged hospital stay and delayed functional recovery (1).