Intrapleural Analgesia before Pleurodesis

Abstract

Intrapleural injection of local anesthetics has proved effective in managing pain caused by various conditions. We used this technique prior to pleurodesis and monitored the effect. Twenty consecutive patients suffering from severe unilateral pleural effusion were included. The investigation was performed double blind. Ten patients received bupivacaine intrapleurally and ten patients received sodium chloride prior to pleurodesis with tetracycline. Pain was scored using the visual analog scale before, and at various intervals after the pleurodesis. The patients in the placebo group had high pain scores and needed supplemental morphine injections. The patients in the bupivacaine group had low pain scores and did not need supplemental morphine. We found that intrapleural injection of bupivacaine prior to pleurodesis with tetracycline was effective in abolishing the pain.