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Repeated Intercostal Nerve Blocks With Liposomal Bupivacaine for Chronic Chest Pain: A Case Report

Visoiu, Mihaela MD*; Verdecchia, Nicole MD

doi: 10.1213/XAA.0000000000001047
Case Reports

Chronic chest pain is a debilitating condition that is poorly treated, resulting in opioid dependence and significantly decreased quality of life. In this case report, we describe the successful use of 266 mg of liposomal bupivacaine for 4 rounds of left-sided multilevel intercostal nerve blocks performed to treat chronic chest pain of a 21-year-old woman (150 kg, 163 cm). The sensory blockade duration was up to 7 days, analgesia lasted 2 months, and was described superior to that with ropivacaine intercostal blockade. The treatment improved satisfaction with pain control and quality of life.

From the *Department of Pediatric Anesthesiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania

Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Accepted for publication May 1, 2019.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

This work will be presented at the Society for Pediatric Anesthesia (SPA) and American Association of Pediatrics (AAP) Meeting March 15–17, 2019, Houston, TX, and the 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting April 11–13, 2019, Las Vegas, NV.

Address correspondence to Mihaela Visoiu, MD, Department of Pediatric Anesthesiology, UPMC Children’s Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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