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The effectiveness and safety of local pleural anesthesia for pain control in patients undergoing CT-guided transthoracic needle biopsy

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Abstract

Objectives

To evaluate the effectiveness and safety of pleural anesthesia for CT-guided transthoracic needle biopsy (TNB).

Methods

This retrospective study was performed between March 2019 and August 2019 in a tertiary care hospital. Patients undergoing CT-guided TNB received either (a) pleural and skin anesthesia (pleural anesthesia group) or (b) skin anesthesia only (skin anesthesia group). Pain score was reported on a 0–5 numeric rating scale, and pain scores 3–5 were classified as significant pain. The relationship between pleural anesthesia and pain score, significant pain, and pneumothorax was assessed by using multivariable linear and logistic regression models.

Results

A total of 111 patients (67 men, 66.0 ± 11.4 years) were included (pleural anesthesia group, 38; skin anesthesia group, 73). Pleural anesthesia group reported lower pain score (1.4 ± 1.0 vs. 2.3 ± 1.1, p < 0.001) and less frequent significant pain (18.4% [7/38] vs. 42.5% [31/73], p = 0.020) than skin anesthesia group. Pain score was negatively associated with pleural anesthesia (β = −0.93, p < 0.001) and positively associated with procedure time (β = 0.06, p < 0.001). Significant pain was negatively associated with pleural anesthesia (p = 0.004, adjusted odds ratio [OR] = 0.21 [95% confidence interval: 0.07, 0.61]) and positively associated with procedure time (p < 0.001, adjusted OR = 1.15 [95% confidence interval: 1.07, 1.24]). Pleural anesthesia was not associated with pneumothorax or chest tube placement (p = 0.806 and 0.291, respectively).

Conclusion

Pleural anesthesia reduces subjective pain without increasing the risk of pneumothorax.

Key Points

• Local pleural anesthesia is a simple method that can be added to the conventional skin anesthesia for CT-guided transthoracic needle biopsy.

• The addition of local pleural anesthesia can effectively reduce pain compared to the conventional skin anesthesia method.

• This procedure is not associated with an increased risk of pneumothorax or chest tube placement.

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Abbreviations

CI:

Confidence interval

CT:

Computed tomography

DLP:

Dose-length product

GGN:

Ground-glass opacity nodule

OR:

Odds ratio

TNB:

Transthoracic needle biopsy

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul, 06591, Republic of Korea

    Kyongmin Sarah Beck, Suyon Chang, Dae Hee Han, Kyung Won Doo & Jung Im Jung

Authors
  1. Kyongmin Sarah Beck
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  2. Suyon Chang
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  3. Dae Hee Han
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  4. Kyung Won Doo
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  5. Jung Im Jung
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Corresponding author

Correspondence to Suyon Chang.

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Guarantor

The scientific guarantor of this publication is Dae Hee Han.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Statistical consultation was supported by the Department of Biostatistics of the Catholic Research Coordinating Center.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Beck, K.S., Chang, S., Han, D.H. et al. The effectiveness and safety of local pleural anesthesia for pain control in patients undergoing CT-guided transthoracic needle biopsy. Eur Radiol 31, 8282–8290 (2021). https://doi.org/10.1007/s00330-021-07969-9

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  • DOI: https://doi.org/10.1007/s00330-021-07969-9

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