Thoracic pain after intercostal nerve blockade in open cholecystectomy

Cholecystectomy is a minor surgery that causes one of the most significant occurrences of postoperative pain. Intercostal nerve blockade is a technique relatively easy to perform, whose benefits by itself are limited, but become more significant when it is associated with other anesthesic blockade or general anaesthesia. The preemptive and multimodal analgesic approach in thoracic surgery by means of intercostal blockades has been studied. The outcomes show a significant decrease of postoperative pain and less worsening of the pulmonary function than those that occurred in control groups.We present the case of a patient who underwent an open cholecystectomy, having unilateral intercostal blockades and he suffered from pain in his right hemithorax and shoulder during the early postoperative period. We review the most important characteristics and side effects of the intercostal blockade to make an etiological diagnosis for the thoracic pain related to it.