Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

Uffe Bodtger; Jos&#233; M. Porcel; Rahul Bhatnagar; Nick Maskell; Mohammed Munavvar; Casper Jensen; Paul Frost Clementsen; Daniel Bech Rasmussen

doi:10.3791/65734

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

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Medicine
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JoVE Journal Medicine

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

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03:22 min

November 10, 2023

DOI: 10.3791/65734-v

Uffe Bodtger^1,2, José M. Porcel³, Rahul Bhatnagar^4,5, Nick Maskell^4,5, Mohammed Munavvar^6,7, Casper Jensen¹, Paul Frost Clementsen^1,8, Daniel Bech Rasmussen^1,2

¹Respiratory Research Unit PLUZ, Department of Respiratory Medicine,Zealand University Hospital, ²Institute of Regional Health Research,University of Southern Denmark, ³Pleural Medicine Unit, Department of Internal Medicine,Hospital Universitari Arnau de Vilanova, IRBLleida, ⁴Respiratory Department, Southmead Hospital,North Bristol NHS Trust, ⁵Academic Respiratory Unit,University of Bristol, ⁶Lancashire Teaching Hospitals, ⁷University of Central Lancashire, ⁸Centre for HR and Education,Copenhagen Academy for Medical Education and Simulation

Overview

Local anesthetic thoracoscopy (LAT) is a crucial procedure for diagnosing recurrent pleural effusion when standard evaluations fail. This article outlines a systematic approach to ensure the procedure is conducted safely and effectively.

Key Study Components

Area of Science

Medical procedures
Thoracic medicine
Diagnostic techniques

Background

LAT is essential for identifying undiagnosed pleural effusions.
It can be performed as a day-case procedure.
Guideline-based workups may not always yield specific causes.
Chest physicians are typically responsible for this procedure.

Purpose of Study

To provide a step-by-step guide for performing LAT.
To enhance the safety and success rate of the procedure.
To assist chest physicians in managing pleural effusions effectively.

Methods Used

Conduct a patient health check and confirm consent.
Position the patient appropriately for the procedure.
Utilize ultrasound guidance for marking the entry site.
Prepare and check all necessary equipment and medications.

Main Results

LAT can be performed safely with proper preparation.
Ultrasound guidance improves accuracy in marking entry points.
Monitoring patient vital signs is crucial throughout the procedure.
Day-case procedures can enhance patient convenience.

Conclusions

LAT is a valuable tool for diagnosing pleural effusions.
Following a structured approach can improve outcomes.
Chest physicians can effectively perform LAT with the right training.

Frequently Asked Questions

What is local anesthetic thoracoscopy?

LAT is a procedure used to diagnose pleural effusions using local anesthesia.

Who performs LAT?

Chest physicians typically perform LAT as a day-case procedure.

How is the entry site marked for LAT?

Ultrasound guidance is used to accurately mark the entry site on the thorax.

What preparations are needed before LAT?

A health check, consent confirmation, and equipment preparation are essential.

Is LAT safe?

Yes, when performed correctly, LAT is considered a safe procedure.

Local anesthetic thoracoscopy (LAT) is essential for diagnosing recurrent, undiagnosed pleural effusion when a guideline-based workup fails to provide a specific cause. LAT can be performed as a day-case procedure by chest physicians. Here, we present a step-by-step approach for a successful and safe procedure.

To begin, perform a patient health check, reaffirming his consent and health conditions. Prepare and check any medications such as sedatives. Place the patient in a lateral decubitus position on a pillow, effusion side up, and ensure patient vital signs monitoring is in place.

With ultrasound guidance, mark the expected entry side on the thorax with a blunt indentation marker. Reconfirm with ultrasound after marking. Once the practitioner has scrubbed and donned the appropriate sterile gear, prepare and check the equipment and local anesthetic which will be used in the procedure.

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