Review Note
Last Update: 02/27/2025 04:23 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
Front
Back
No published tags.
Pending Suggestions
Field Change Suggestions:
Front
Commit #291080SS_TS 1.14 Outline the anaesthetic management of the following procedures: • Pleuredesis
Back
Commit #291080- Indication: recurrent PTX, pleural effusions
Preop:
- Recent CXR
- Active respiratory infections treated
- Preoperative ICD if PTX present
Periop
- Keep Paw as low as possible
- Aim for full expansion of lung at the end of procedure, check on post op CXR
- Adequate analgesia; pleurodesis painful ++
- NSAIDs avoided as they can dampen anti-inflammatory effects of pleurodesis
- PVB unsuitable (damaged pleura), intercostal blocks good, plane blocks good
Special considerations
- Malignant pleural effusions can cause significant respiratory compromise including mediastinal shift
- Massive effusions (>2000mls, >⅔ hemithorax on CXR) should have tap or partial drainage preop; rapid intraoperative reinflation can cause re-expansion pulmonary oedema