• Medicine · Jul 2021

    Evaluation of the position of the needle tip during thoracentesis: Experimental study.

    • Masafumi Shimoda, Kozo Morimoto, Yoshiaki Tanaka, Kozo Yoshimori, and Ken Ohta.
    • Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose City, Tokyo, Japan.
    • Medicine (Baltimore). 2021 Jul 16; 100 (28): e26600e26600.

    IntroductionThoracentesis is performed to both diagnose and/or treat pleural effusion, and several important complications of thoracentesis are occasionally observed. To assess precise thoracentesis procedures, we evaluated the position of the needle tip during thoracentesis by using a thoracentesis unit, comparing experienced and inexperienced groups.MethodsTwenty eight physicians (19 board-certified pulmonologists as an experienced group and the remaining 9 as an inexperienced group) participated at Fukujuji Hospital in January 2021. All participants performed 2 punctures with a handmade thoracentesis unit and measured the needle's angle to the midline.ResultsThe median distance from the needle tip to the midline when the needle was inserted 5 cm (D5) was 0.47 cm (range 0.06-1.05), and the median difference between D5 on the 1st puncture (D51st) and D5 on the 2nd puncture (D52nd) was 0.22 cm (range 0.00-0.69). D5 was shorter in the experienced group than in the inexperienced group (median 0.40 cm (range 0.06-0.66) vs 0.58 cm (range 0.44-1.05), P < .001). There were no significant differences in the D51st and D52nd distances between the experienced and inexperienced groups (median 0.22 cm (range 0.00-0.40) vs 0.41 cm (range 0.04-0.69), P = .094). When 4 areas were divided by the x-axis and y-axis, 32 punctures (55.2%) deviated to the right-upper quadrant, and 25 (86.2%) of participants made the 1st puncture and 2nd puncture in the same direction.ConclusionsAll doctors should know that the needle direction might shift by approximately 1 cm, and more than half of the practitioners punctured towards the upper right.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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