Évaluation de l’anesthésie locale à la Xylocaïne tamponnée pour les abords pleuraux : étude DOULAPLUX

Abstract

Introduction: Pleural procedures are painful interventions. While there exist recommendations aimed at preventing the pain induced by local anesthesia, they have never been evaluated with regard to the thoracic wall. The objective of this study is to evaluate the effectiveness of a specific local anesthesia technique in pleural procedures.Methods: Descriptive, monocentric, prospective study, including all initial pleural procedures performed in our unit. Pain was assessed 20 minutes after the procedure using the VAS (Visual Analog Scale) or the NRS (Numerical Rating Scale).Results: Two hundred and fifty-one patients were included. The procedures included thoracocentesis (58%), pleural or pulmonary biopsy (28%), or drainage (14%). Average pain intensity was 0.6 on a scale of 10. Over two thirds (68%) of patients had a VAS or NRS score of 0, and 91% ≤ 2. While infectious pleuritis, pneumothorax, and drainage were the most painful interventions, the pain levels remained acceptable (average VAS/NRS scores of 1.3, 1.8, 1.7 respectively).Conclusion: Buffered lidocaine local anesthesia provides excellent pain control for pleural procedures, regardless of their nature. Recommendations regarding local anesthesia apply to the thoracic wall, and their dissemination is essential to reduction of the pain induced by pleural procedures.