Talk:Intercostal nerve block

Concerns

I'm not an expert but I'm concerned about this article's accuracy.

Definition

"Intercostal nerve block (abbreviated ICNB) is a medical procedure in which a local anesthetic is injected into the immediate vicinity of the intercostal nerve as it lies in the costal groove on the internal surface of the rib."

• Local anesthetic or corticosteroid or both may be used in an anesthetic nerve block.^[1]
• There are other types of nerve block than anesthetic. Intercostal neurolysis (deliberate degeneration of nerve fibers to produce a block lasting months),^[2] and intercostal neurectomy (cutting through or removing a nerve to produce a nominally permanent block)^[3] are types of nerve block not involving anesthetic or corticosteroid.

I could be misreading the sources, but that's how it seems to me. If I'm right it may be necessary to make it clear that this article discusses anesthetic intercostal nerve blockade, and say something about neurolysis and neurectomy. --Anthonyhcole (talk · contribs · email) 13:57, 4 January 2014 (UTC)

@Anthonyhcole: Thanks for heads up. I improved the definition. As for types of ICNB, they're well covered in the section about Techniques. Alex ^{discussion ★} 07:27, 5 January 2014 (UTC)

Copyvio

This article is largely sourced to Lennard, Pain Procedures in Clinical Practice. Because the voice changes and is at odds with the main editor's writing style, I requested a close paraphrasing check at DYK. I have just looked and found:

1. This sentence is taken verbatim from Lennard: "The twelve pairs of thoracic spinal nerves (T1-12) are divided into ventral and dorsal rami after they pass through the intervertebral foramina."
2. I don't have access to all of Lennard via google books preview, but everything else that I've checked is extremely close paraphrasing, to the point of likely copyvio of the entire chapter (31).
3. A google books preview for this source is available, and I cannot verify this text from page 461 of that book:

   Nerve blocks may involve the injection of local anesthetic, corticosteroid or both into the immediate vicinity of the nerve ("anesthetic block"), which provides pain relief usually lasting hours or days,[1]

4. There is no reason for a 13-page range for citing one sentence: I have not attempted to search the 13 pages to verify or check for copyvio on one sentence cited to this source. The exact page should be provided.

   Optionally, the procedure can be performed with or without ultrasound image guidance. ^ Erdine, P. Prithvi Raj, Serdar. Pain-relieving procedures : the illustrated guide. Chichester, West Sussex: Wiley-Blackwell. pp. 14–27. ISBN 047067038X.

5. Similarly, for this source, the page range is much too large for verification; individual pages should be supplied for a range this large:

   Moore, Keith L. Moore, Anne M.R. Agur ; in collaboration with and with content provided by Arthur F. Dalley II ; with the expertise of medical illustrator Valerie Oxorn and the developmental assistance of Marion E. (2007). Essential clinical anatomy (3rd ed. ed.). Baltimore, MD: Lippincott Williams & Wilkins. pp. 48–65. ISBN 078176274X.

6. There is also copyvio or very close paraphrasing from this source, samples:

   Source: Proximal blockade of these nerves using local anesthetics is among the oldest of peripheral nerve blocks, having been described as early as 1907.1

   Text: Proximal blockade of intercostal nerves using local anesthetics is among the oldest of peripheral nerve blocks, and it was first described in early 1907.

   Source: By 1922, a detailed account of intercostal nerve blocks was recorded that is much the same as today’s approach.

   Text: By 1922, a detailed account of intercostal nerve blocks was recorded, and it was very similar to modern medical knowledge.

I have not checked further as, at this point, it is apparent that there is a serious problem in this article. SandyGeorgia (Talk) 16:43, 13 January 2014 (UTC)

Intercostal Nerve Block Stub Expansion

One of the main additions I made to this article was to describe the injuries in which an ICNB would be used. This helps the reader visualize and conceptualize the meaning of the term "intercostal nerve block" if they are unfamiliar with the conditions associated with the term.

I also tried to use plain language instead of medical jargon when possible. I hyperlinked technical terms to other Wikipedia articles to make it easy for the reader to find a confusing word.

After reading previous comments listed in this talk page, I decided to add a section that makes clear the distinction between anesthetic nerve blockages and neurolysis. This clears up the ambiguity that could have been associated with the term before. I also added lots of hyperlinks to other Wikipedia pages so that readers can easily find terms they aren't familiar with in this article.