Pleurodesis

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Pleurodesis is the artificial obliteration of the pleural space. It is done to prevent recurrence of pneumothorax or pleural effusion. It can be done chemically or surgically.

Chemicals such as bleomycin, tetracycline, povidone iodine, or a slurry of talc can be introduced into the pleural space through a chest drain. The instilled chemicals cause irritation between the parietal and the visceral layers of the pleura which closes off the space between them and prevents further fluid from accumulating.

Chemical pleurodesis is a painful procedure, so patients are often premedicated with a sedative and analgesics.. A local anesthetic may be instilled into the pleural space, or an epidural catheter may be placed for anesthesia.

Surgical pleurodesis is performed via thoracotomy or thoracoscopy. This involves mechanically irritating the parietal pleura, often with a rough pad. Moreover surgical removal of parietal pleura is an effective way of achieving stable pleurodesis