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CardioVascular and Interventional Radiology

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Open Access 19-04-2024 | Pneumothorax | Clinical Investigation

Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung

Authors: Andrea Goetz, Florian Poschenrieder, Frederike Georgine Steer, Florian Zeman, Tobias J. Lange, Sylvia Thurn, Barbara Greiner, Christian Stroszczynski, Wibke Uller, Okka Hamer, Simone Hammer

Published in: CardioVascular and Interventional Radiology | Issue 5/2024

Abstract

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-, procedure- and 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.

Graphic Abstract

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Title: Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung
Authors: Andrea Goetz
Florian Poschenrieder
Frederike Georgine Steer
Florian Zeman
Tobias J. Lange
Sylvia Thurn
Barbara Greiner
Christian Stroszczynski
Wibke Uller
Okka Hamer
Simone Hammer
Publication date: 19-04-2024
Publisher: Springer US
Keywords: Pneumothorax
Pneumothorax
Pneumothorax
Piritramide
Opioids
Opioids
Computed Tomography
Computed Tomography
Published in: CardioVascular and Interventional Radiology / Issue 5/2024
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-024-03717-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung

Abstract

Purpose

Materials and Methods

Results

Conclusion

Level of Evidence 4

Graphic Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

Level of Evidence 4

Graphic Abstract

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