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Doctor insights on: Pain From A Thoracentesis Procedure

Varies: That's actually a very complicated question to answer due to lack of price transparency in healthcare. It differs based on your insurance status, level of thoracentesis (image guided, need for pigtail, etc.). CMS reimburses physicians about $50 - $100 for each of these, but you may get billed for much more ($200-$400) depending on insurance (+ facility fee)

Chest x-ray: No fluid (or less fluid) on chest x-ray and no sign of pneumothorax (punctured lung.).

Depends: You probably mean decrease INR with vitamin k. So without knowing details at all, I would say that it probably depends upon how urgent it is. Maybe they want the INR to drift down on it's own and then try. You can certainly discuss this more

Thoracentesis: Thoracentesis is a procedure that allows removal of fluid from the pleural space (the space between the lungs and the rib cage). Normally there should be little or no fluid there. If fluid does accumulate a physician can insert a needle between the ribs (under local anesthesia) and drain some or all of the fluid. The fluid can then be tested to see what caused its accumulation.

Procedure: Medical procedure used to remove excessive fluid from the lungs. It can be done to relieve pressure, improve oxygenation and decrease symptoms such as shortness of breath or chest pain or can be done to evaluate fluid to rule out cancer, TB etc.

Fluid drain fm chest: When there is fluid between the chest wall and the lung, it may be drained for diagnostic of therapeutic purposes using a needle and an evacuated jar.

Yes: This is usually done with a little local anesthesia +/- a very little sedation.

Remove pleural fluid: When a patient has fluid around the lungs, sometimes we need to find out what caused it, other times we want to remove the fluid so the patient can breath easier. It takes place under sterile conditions by placing a needle into the chest wall from the back and connecting the needle with a catheter to a suction bottle which collects the fluid. Fluid is then sent for testing.

Depends: There are a number of potential complications assoc w/ a thoracentesis. That being said, most of the time the procedure is safe. It is not unusual for patients to experience pain related to the needle placement through the plueral suface which is just outside the lung. Please check with your doctor that nothing more serious is going on, particularly if you have difficult breathing.

Unlikely: That is very unlikely. A collapsed lung (pneumothorax) is the most common complication.

Not necessarily: Only when large collection of fluid accumulates.

See below: Thoracentesis is when fluid is removed from the space between your lung and the chest wall with a needle - usually done to relieve pressure, or send a culture. Bronchoscopy is done to look inside your airways with a camera (bronchoscope). It is done for numerous reasons: clean up secretions, look at anatomy, investigate tumors, obtain biopsies, and others.

Not really: If pleurisy is associated with pleural effusion and symptoms warrant then it should be tapped.

Procedures: Thoracentesis is done to draw out fluid if there is accumulation of fluid between the lining of the lung and the chest wall. Bronchoscopy is done to look inside the airways in the lungs as in looking for tumor, bleeding, diagnose infections and sometimes in treatment as in bronchoplasty and stent placement.

Pancreas: To try and determine where is has or is coming from. Amylase may be a sign that that there is a problem with the pancreas nad although rare may be foind in thoracentesis fluid.

Doctor: Usually your doctor makes the decision. Follow up with them.

Pleurisy, no: But pleural effusions usually should be investigated by a thoracentesis unless the cause is obviously heart failure. Even then, an initial thoracentesis should be done to confirm the cause. If you argue that not all effusions require a thoracentesis, then I need to know if you'll defend me if/when I get sued for missing an empyema or mesothelioma.

Several: Infection, bleeding. Collapsed lung---treat cause of recurrent fluid in the chest.

Posterolateral: Today most thoracentesis is ultrasound guided to avoid injury to lungs, liver or other structures. It is typically done along the posterior axillary line, intercostal space is primarily determined by location of pleural fluid.

Yes: A doctor will usually want a few simple blood tests to make sure you do not have some potential for bleeding prior to a thoracentesis. It depends a lot on what medications you are currently taking, especailly blood thinning medications and your general level of health at the time of the thoracentesis. A protime test and a blood count are typical tests to do prior.