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Updated: Jul 18, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
A spray catheter technique for pleural anesthesia: a novel method for pain control before talc poudrage
1Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. lee.pyng@sgh.com.sg
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.
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