Role of simple needle aspiration in the management of spontaneous pneumothorax

Abstract

Objective: To determine the efficacy of simple needle aspiration in the management of primary spontaneous pneumothorax. Not all patients with pneumothorax require intercostal tube drainage (ICTD). Some patients can be managed conservatively by simple needle aspiration of air from pleural space. It is a cheap and easy alternative to ICTD which can be done on out patient basis.

Materials and methods: All patients of spontaneous pneumothorax presenting for the first time were included in this study, after obtaining baseline investigations like chest X-ray, ECG, serum creatinine, blood sugar etc. They were managed by ICTD or simple needle aspiration. Chest X-ray was done 6 hours after the procedure (ICTD), 24 hours after aspiration and prior to ICTD removal or before hospital discharge. Patients who had undergone simple needle aspiration were allowed to go home following a few hours of observation after explaining the warning symptoms and the need for reevaluation after 24 hrs, if prompt follow-up could be ensured otherwise they were admitted along with patients undergoing ICTD.

Results: Eighty two patients of spontaneous pneumothorax were included in this study during a-period of 12 months (May- 04 to April - 05). Out of these 40 (49%) patients were managed by ICTD, 42 (51%) patients were subjected to simple needle aspiration. Thirty two (76%) patients responded to simple needle aspiration while the remaining 10 patients required ICTD finally. There were no complications in the patients managed by simple needle aspiration; they had less chest pain and lesser duration of hospital stay.

Conclusion: Spontaneous pneumothorax may be managed by simple needle air aspiration primarily, unless contraindicated (tension pneumothorax), or in patients requiring mechanical ventilation. For symptomatic patient it is the recommended procedure.