Abstract
Background: TUS has been widely shown to reduce rates of complications following pleural intervention. We hypothesised direct (“realtime”) US guidance would result in better local anaesthetic infiltration of the pleura and a decrease in procedural pain scores.
Methods: Patients with a moderate to large pleural effusion of any aetiology requiring a large volume thoracocentesis were prospectively assigned to either a direct or indirect US-guided procedure. 100 mm VAS pain scores were performed pre-procedure, immediately post-procedure and 30-minutes post drainage.
Results: 24 patients were included and randomly assigned to receive direct or indirect US-guided anaesthesia and catheter insertion (complete results in Figure 1). The median VAS scores pre-procedure (1mm, IQR=1-4.75) to immediately post-procedure (1mm, IQR=1-3.25) in the direct US group did not change, whilst in the indirect US group, it rose from 2.5mm (IQR=1-12.25) to 17.5mm (IQR=1-29), representing a 15 mm change. Both groups demonstrated an increase in pain score 30-minutes post-procedure (Figure 2). There were no significant differences in pre-procedure VAS scores between groups. There was a signal towards improvement in VAS pain scores immediately post-procedure in the direct US group when compared to indirect, but this failed to meet statistical significance (Mann-Whitney U test, p = 0.068).
Conclusion: An improvement in pain scores immediately post-procedure was observed in the direct US group, however, without statistical significance, we are unable to reject the null hypothesis. We would recommend an adequately powered study with an increase in sample size to further evaluate this hypothesis.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3787.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021