Patients usually complain of severe postoperative pain at the rib cartilage recession site after total ear reconstruction surgery. We evaluated the postoperative analgesic effects of an intercostal nerve block (ICNB) in patients undergoing total ear reconstruction.

We injected normal saline (2 ml/rib space) in the control group (n = 15), and 0.75% ropivacaine (2 ml/rib space) in the ICNB group (n = 15) respectively into the 6th, 7th and 8th intercostal spaces following the induction of general anesthesia for surgery. Mean arterial pressures and heart rates were measured pre-ICNB, post-ICNB, pre-surgical incision, 10, 30 and 60 minutes after incision. Numerical rating scales (NRS: 0 = no pain, 10 = most severe pain) were measured at a postoperative 6, 12, 24, 36 and 48 hours by NRS-resting and NRS-coughing, respectively.

Mean arterial pressures and heart rates were significantly more stable (P < 0.05) in the ICNB group at 10, 30 and 60 min after incision, than in the control group. NRS were low in all of the ICNB group throughout the postoperative period versus the control group.

We conclude that ICNB induce stable vital signs during rib recession and has excellent postoperative analgesic effects. Thus, we recommend periop-ICNB for total ear reconstruction surgery for the management of anesthesia and postop-analgesia.