Page 180 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 12 · Pleural drainage techniques
Chapter 12 · Pleural drainage techniques

OPERATIVE TECHNIQUE 12.2
VetBooks.ir Small-bore wire-guided chest drain placement in

a closed chest

PATIENT PREPARATION AND POSITIONING

It is ideal if the animal tolerates pre-oxygenation, clipping and surgical preparation of the chest prior to sedation. A
large area of the right or left lateral chest, including the entire rib cage, is clipped and surgically prepared. The animal is
usually in sternal recumbency but can be in lateral recumbency if this is tolerated without respiratory compromise. A
2% lidocaine (0.2 ml/kg) local anaesthetic block is infused into the site of skin incision.
WARNING

Never attempt to place a chest drain in an animal with severe respiratory compromise.
Stabilization with oxygen, thoracocentesis and cage rest is indicated first

ASSISTANT
One person is required to monitor and restrain the patient.

ADDITIONAL INSTRUMENTS
Multifenestrated 14 G chest drain catheter kit (Chest Tube –
Guidewire inserted; MILA International), three-way tap, two
bungs; 20–50 ml syringe.

SURGICAL TECHNIQUE
1 The 14 G introducer catheter and stylette is tunnelled subcutaneously in a cranioventral direction for several rib
spaces and inserted into the pleural cavity at the seventh or eighth intercostal space towards the cranial edge of
the rib to minimize risk of injury to the caudally situated neurovascular bundle. Make sure the introducer catheter
and stylette is fully advanced into the thorax.
2 Remove the stylette and immediately introduce a J-wire through the catheter in a cranioventral direction for
10–20 cm or until resistance is met.

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