A spray catheter technique for pleural anesthesia: a novel method for pain control before talc poudrage.
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%.


CONCLUSIONS
Lidocaine via spray catheter is effective for pain control before pleurodesis.
Lee
Pyng
P
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. lee.pyng@sgh.com.sg
Colt
Henri G
HG
D000368:Aged; D000765:Anesthesia, Conduction / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D016066:Pleural Effusion, Malignant / Q000517:prevention & control*; D018700:Pleurodesis / Q000009:adverse effects*; D011030:Pneumothorax / Q000628:therapy*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D013627:Talc / Q000008:administration & dosage*
D013627:Talc