What an Intercostal Tube Insertion?      

In between the ribs, a tube is placed into the pleural space (space between the lung and the chest wall) to drain the air or fluid from that space. Your medical condition will determine the position of insertion.      

After using an injection of local anesthetic, a small cut is made into the skin and tissue so that the chest tube can be placed into the pleural space. The tube is stitched to the skin and attached to a drainage bottle. The tube may be painful, especially when you move or cough, requiring pain killers.    

After the procedure, a chest X-ray is taken to check the correct position.  

The tube is removed when air has stopped draining from the chest or the amount of fluid draining has reduced or stopped. To be removed, the tube is pulled out by your doctor and some stitches may be needed to close the wound.  

A chest X-ray is done after tube removal. The doctor will tell you when to remove the stitches and the dressing. The wound and dressing are to be kept dry for 2 days.  

This procedure will require an anesthetic: Local anesthetic and, sometimes, sedation for your procedure. Local anesthesia is generally very safe, but any anesthetic can have side effects or complications  

Anesthetic side effects

Common

  • Local pain and bruising at the injection    

Uncommon  

  • Allergy to the local anesthetic solution    Temporary nerve damage (days to months), causing local weakness and/or numbness
  • Ineffectiveness or does not work, requiring a further injection of anesthetic or a different type    
  • Local infection requiring antibiotics and further treatment    
  • Damage to nearby structures such as blood vessels, nerves and muscles    

Rare  

  • Permanent nerve    Death (Extremely rare)    
  • Overdose of local  
  • Seizures    
  • Cardiac arrest  

Before and after the procedure      

  • Do not eat or drink anything for at least six hours before the procedure    
  • Coagulation analysis should be done within 2 months before the procedure. If using Anticoagulants or Aspirin inform your doctor as you probably will need to stop/change them
  • Bring your X-rays or CT scans with you    
  • Contact your doctor or hospital:    
  • If you have a fever that does not go away    
  • If you have oozing or discharge from the wound    
  • IMMEDIATELY if you have difficulty in breathing    

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