From the Research
Patients do not need to be NPO (nothing by mouth) before a thoracentesis procedure, as the procedure is typically performed under local anesthesia and does not require sedation that would increase aspiration risk 1. The most recent and highest quality study, published in 2020, supports the safety of symptom-limited thoracentesis using suction, with a low incidence of complications such as pneumothorax and re-expansion pulmonary edema 1.
Key Considerations
- Thoracentesis is a relatively safe procedure with a low risk of major complications, such as pneumothorax and bleeding, as reported in a study published in 2016 2.
- The use of ultrasound and operator expertise can reduce the risk of complications, as noted in a study published in 2016 2.
- Patients with specific medical conditions that may increase aspiration risk, such as those undergoing conscious sedation, may require individualized assessment and possible fasting for 4-6 hours beforehand.
- Maintaining normal hydration before thoracentesis can be beneficial, as it may make it easier to access the pleural fluid during the procedure.
Procedure Details
- The procedure involves inserting a needle into the pleural space to remove fluid, which does not interfere with food or liquid in the stomach.
- Local anesthesia is typically used before thoracentesis, but it may alter the pH of the pleural fluid, as reported in a study published in 1999 3.
- The decision to fast or not should be made on an individual basis, taking into account the patient's specific medical condition and the type of procedure being performed.