• Sebastiano Mercadante.
• Director of Anesthetics, La Maddalena Cancer Center, (S.M.), Main Regional Center of Pain Relief and Supportive/Palliative Care, Palermo, Italy. Electronic address: terapiadeldolore@lamaddalenanet.it.
• J Pain Symptom Manage. 2023 Sep 1; 66 (3): e427e429e427-e429.

IntroductionRib metastases may cause incident pain on coughing, deep respiration, or on specific thoracic wall movement. Proper titration of opioid doses relieves the background pain adequately, but does not allow a good pain control for incident pain.MethodsA patient with rib metastases presented incident pain due to minimal chest wall movement, limiting breathing. Alcoholization of intercostal nerves at T6,T7, T8, and T9, at level of ribs angle, RESULTS: Intercostal blocks were highly effective in relieving incident pain due to rib metastases.DiscussionA simple and safe procedure may produce effective analgesia preventing incident pain due to rib metastases. Differently from other sites of bone metastases, ribs are easily localized and the neurolytic block results to be effective and safe.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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