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Updated: Jun 6, 2025

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
[Evaluation of local anesthesia with buffered Xylocaine in pleural procedures: The DOULAPLUX study]
V Guiraud-Chaumeil1, H Goussault2, A Boudjemaa1
1Service de pneumologie, centre hospitalier intercommunal de Créteil, 94010 Créteil, France; G-ECHO, Groupe échographie thoracique du pneumologue, Société de pneumologie de langue française, Paris, France.
Introduction:
Pleural procedures are painful interventions. While there exist recommendations aimed at preventing pain induced by local anesthesia, they have never been evaluated with regard to the thoracic wall. The objective of this study was to evaluate the effectiveness of buffered lidocaine local anesthesia in pleural procedures.
Methods:
Descriptive, monocentric, prospective study, including all initial pleural procedures performed in our unit. Pain was assessed 20minutes after the procedure using the VAS (Visual Analog Scale) or the NRS (Numerical Rating Scale).
Results:
Two hundred and fifty-one patients were included. The procedures included thoracocentesis (58%), pleural or pulmonary biopsy (28%), or drainage (14%). Average pain intensity was 0.6 on a scale of 10. Over two thirds (68%) of patients had a VAS or NRS score of 0, and 91%≤2. Infectious pleuritis, pneumothorax, and drainage were associated with more pain. The pain levels were acceptable (average VAS/NRS scores of 1.3, 1.8, 1.7 respectively).
Conclusion:
Buffered lidocaine local anesthesia provides excellent pain control for pleural procedures, regardless of their nature. Recommendations regarding local anesthesia apply to the thoracic wall, and their dissemination is essential to reduction of the pain induced by pleural procedures.
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