Purpose CT-guided percutaneous core biopsy of the lung
is usually performed under local anesthesia, but can also be
conducted under additional systemic opioid medication.
The purpose of this retrospective study was to assess the
effect of intravenous piritramide application on the pneumothorax
rate and to identify risk factors for post-biopsy
pneumothorax.
Materials and Methods One hundred and seventy-one core
biopsies of the lung were included in this retrospective
single center study. The incidence of pneumothorax and
chest tube placement was evaluated. Patient-, procedureand
target-related variables were analyzed by univariate
and multivariable logistic regression analysis.
Results The overall incidence of pneumothorax was 39.2%
(67/171). The pneumothorax rate was 31.5% (29/92) in
patients who received intravenous piritramide and 48.1%
(38/79) in patients who did not receive piritramide. In
multivariable logistic regression analysis periinterventional
piritramide application proved to be the only independent
factor to reduce the risk of pneumothorax (odds ratio 0.46,
95%-confidence interval 0.24, 0.88; p = 0.018). Two or
more pleura passages (odds ratio 3.38, 95%-confidence
interval: 1.15, 9.87; p = 0.026) and prone position of the
patient (odds ratio 2.27, 95%-confidence interval: 1.04,
4.94; p = 0.039) were independent risk factors for a higher
pneumothorax rate.
Conclusion Procedural opioid medication with piritramide
proved to be a previously undisclosed factor decreasing the
risk of pneumothorax associated with CT-guided percutaneous
core biopsy of the lung.
Level of Evidence 4 small study cohort.