Mustafa Kamal, Arshad Javaid, Zia Ullah, Anila Basit, Mohammad Yousaf.
Comparison of post pleurodesis pain with and without lignocaine in patients with malignant pleural effusion.
Pak J Chest Med Jan ;18(03):23-9.

Background: Chemical pleurodesis, using an intrapleural sclerosing agent, is a good palliative measure to obliterate the pleural space, prevent fluid accumulation and improve breathing in patients with malignant pleural effusions. Lignocaine is usually administered intrapleurally just prior to pleurodesis for the relief of pain. Objective: To compare the post pleurodesis pain with and without lignocaine in patients with malignant pleural effusions by using Visual Analog Pain Scale. Methods: 188 patients were randomized into two groups. Tetracycline was used as sclerosing agent for chemical pleurodesis. Group I comprised of patients in whom Lignocaine was not used along with sclerosant and Group II included those in whom injection Lignocaine 2% (200mg) was administered intrapleurally through intercostal tube 15 minutes prior to the administration of sclerosant. Pain was assessed twice by using Visual Analog Pain Scale (VAS), 15 minutes after pleurodesis (VAS1) and 2 hours after pleurodesis (VAS2). Results: Metastatic adenocarcinoma (specify the primary if known, otherwise mention ‘unknown primary’) was the commonest malignancy, 81 (43.08%) cases, followed by 49 (26.5%) cases of Mesothelioma. Mean age was 58.405+14.854 SD in Group I and 53.68+13.22SD in Group II. In Group I, VAS1 mean was 7.17cm+1.13while & VAS2 was 6.64+1.155. In Group II VAS1 mean was 4.85cm+0.792and VAS2 mean was 4.139+0.747. Comparison of the intensity of pain in both groups for VAS1 and VAS2, showed significant difference with "p" value <0.001. Conclusion: Post-pleurodesis pain was significantly reduced with the administration of lignocaine prior to pleurodesis.

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