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The Probert Encyclopaedia of Medicine

PARACENTESIS THORACIS

Paracentesis thoracis is a simple procedure in which a needle is introduced through an intercostal space in order to withdraw pleural fluid for pathological examination or to relieve pressure on the lung. It is carried out under local anaesthesia and apart from syringes, needles and the anaesthetic solution, no special apparatus is required. Penicillin or other antiseptic solution may be injected at the end of the aspirating procedure. Paracentesis for the withdrawal of large pleural effusions requires the addition of a two-way tap or special aspiration apparatus. The ' Potain's' aspirator is sometimes used. For paracentesis following thoracic operations air-pressure adjustments are frequently necessary and an artificial pneumothorax apparatus is required. This machine measures the intra-pleural pressure in expiration and inspiration. Special needles are used for the induction or refill of pneumothorax to provide a connection for the pressure gauge. Following paracentesis there are two main risks: (a) the development of a haemothorax from inadvertent puncture of the lung surface, with subsequent bleeding. (b) surgical emphysema from an escape of air from the pleural space into the subcutaneous tissues.
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