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.
Eur Radiol. 2021 Nov;31(11):8282-8290. doi: 10.1007/s00330-021-07969-9. Epub 2021 Apr 22.
To evaluate the effectiveness and safety of pleural anesthesia for CT-guided transthoracic needle biopsy (TNB).
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.
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).
Pleural anesthesia reduces subjective pain without increasing the risk of pneumothorax.
• 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.
评估胸膜麻醉在 CT 引导下经胸穿刺活检（TNB）中的有效性和安全性。
这是一项回顾性研究，于 2019 年 3 月至 2019 年 8 月在一家三级保健医院进行。接受 CT 引导 TNB 的患者接受以下两种方式之一的麻醉：（a）胸膜和皮肤麻醉（胸膜麻醉组）或（b）仅皮肤麻醉（皮肤麻醉组）。疼痛评分采用 0-5 数字评分量表报告，评分 3-5 分被归类为显著疼痛。采用多变量线性和逻辑回归模型评估胸膜麻醉与疼痛评分、显著疼痛和气胸之间的关系。
共纳入 111 例患者（67 例男性，66.0±11.4 岁）（胸膜麻醉组 38 例，皮肤麻醉组 73 例）。与皮肤麻醉组相比，胸膜麻醉组的疼痛评分（1.4±1.0 对 2.3±1.1，p＜0.001）和显著疼痛发生率（18.4%[7/38]对 42.5%[31/73]，p=0.020）均较低。疼痛评分与胸膜麻醉呈负相关（β=-0.93，p＜0.001），与手术时间呈正相关（β=0.06，p＜0.001）。显著疼痛与胸膜麻醉呈负相关（p=0.004，调整后的优势比[OR]为 0.21[95%置信区间：0.07，0.61]），与手术时间呈正相关（p＜0.001，调整后的 OR 为 1.15[95%置信区间：1.07，1.24]）。胸膜麻醉与气胸或胸腔引流管放置无关（p=0.806 和 0.291）。
胸膜麻醉可减轻主观疼痛，而不增加气胸风险。
局部胸膜麻醉是一种简单的方法，可在 CT 引导下经胸穿刺活检中添加到常规皮肤麻醉中。
与常规皮肤麻醉方法相比，添加局部胸膜麻醉可有效减轻疼痛。
该操作与气胸或胸腔引流管放置无关。
