Thoracentesis

Why It Is Done

Thoracentesis may be done to:

• Find the cause of excess pleural fluid (pleural effusion).
• Relieve shortness of breath and pain caused by a pleural effusion.

How To Prepare

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

How It Is Done

This procedure may be done in your doctor's office, in the X-ray department of a hospital, in an emergency room, or at your bedside in the hospital.

You will need to take off all or most of your clothes (you may be allowed to keep on your underwear if it does not interfere with the procedure). You will be given a cloth or paper covering to use during the procedure. During the procedure, you will be seated but leaning forward on a padded bedside table. X-rays or an ultrasound may be used to locate the fluid in your chest.

The needle site between your ribs will be cleaned with an antiseptic solution. Your doctor will give you a local anesthetic in your chest wall so you won't feel any pain when the longer needle that withdraws the fluid is inserted. When the area is numb, your doctor will insert the needle to where the fluid has collected (pleural space). You may feel some mild pain or pressure as the needle enters the pleural space.

Your doctor will use a syringe to remove a sample of fluid. If larger amounts of pleural fluid are removed, a small tube attached to a vacuum bottle is used. Your doctor will send the fluid to the lab. After the fluid is removed, the needle or small tube is removed. Then a bandage is put on the site.

After the test

An X-ray may be taken right after the procedure to make sure that no complications have occurred.

How long the test takes

This procedure takes about 10 to 15 minutes.

How It Feels

When you are given the shot to numb your skin at the needle site, you will feel a sharp stinging or burning sensation that lasts a few seconds. When the needle is inserted into the chest wall, you may again feel a sharp pain for a few seconds.

When the pleural fluid is removed, you may feel a sense of "pulling" or pressure in your chest. Tell your doctor or nurse if you feel faint or if you have any shortness of breath, chest pain, or uncontrollable cough.

Risks

Thoracentesis is generally a safe procedure. A chest X-ray may be done right after the procedure to make sure that no complications have occurred. Complications may include:

• A partial collapse of the lung (pneumothorax).
• Fluid buildup in the lung.
• Infection.
• Bleeding.
• Damage to another organ, such as the liver or spleen.

Results