Pyng Lee1, Henri G Colt. 1. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. lee.pyng@sgh.com.sg
Abstract
BACKGROUND: Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS: Patients were premedicated with IM pethidine and IV midazolam. The pleural space was examined with the flex-rigid pleuroscope. Before talc poudrage, 250 mg lidocaine was administered via spray catheter, and pain scores measured immediately after the procedure and on postoperative days 1 and 2 were 3, 2, and 2, respectively. RESULTS: No complications were noted, and 30-day mortality was 0%. CONCLUSION: Lidocaine via spray catheter is effective for pain control before pleurodesis.
BACKGROUND: Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS:Patients were premedicated with IM pethidine and IV midazolam. The pleural space was examined with the flex-rigid pleuroscope. Before talc poudrage, 250 mg lidocaine was administered via spray catheter, and pain scores measured immediately after the procedure and on postoperative days 1 and 2 were 3, 2, and 2, respectively. RESULTS: No complications were noted, and 30-day mortality was 0%. CONCLUSION:Lidocaine via spray catheter is effective for pain control before pleurodesis.
Authors: Jeremy R Hogg; Michael Caccavale; Benjamin Gillen; Gavin McKenzie; Jay Vlaminck; Chad J Fleming; Andrew Stockland; Jeremy L Friese Journal: Semin Intervent Radiol Date: 2011-03 Impact factor: 1.513