COMPARISON OF REAL-TIME ULTRASOUND GUIDED THORACENTESIS WITH BLIND TECHNIQUE

Background: Pleural effusion, the abnormal accumulation of fluid in the pleural space, remains a frequent clinical and diagnostic challenge. Identifying its etiology and managing fluid drainage effectively are essential to prevent respiratory distress and complications. Thoracentesis, whether performed blindly or under imaging guidance, plays a pivotal role in both diagnosis and therapy. Real-time ultrasonography has emerged as a safer and more efficient alternative, improving procedural precision and reducing iatrogenic risks. Objective: To compare the efficacy and safety of real-time ultrasound-guided thoracentesis with the conventional blind technique. Methods: This experimental study was conducted at Captain Medical Complex, Garh Mor, over a 12-month period following ethical approval. A total of 102 patients were randomly allocated into two groups: 51 underwent ultrasound-guided thoracentesis and 51 underwent the blind technique. Patients aged 20–60 years with clinically and radiologically confirmed pleural effusion exceeding 200 mL were included. Data regarding demographic variables, fluid volume tapped, and post-procedural complications were analyzed using SPSS software, with a significance level set at p ≤ 0.05. Results: The mean age in the blind and ultrasound-guided groups was 48.16 ± 7.99 and 47.71 ± 6.80 years, respectively. The mean volume of pleural fluid aspirated was higher in the ultrasound-guided group (198.04 ± 363.8 mL) compared to the blind group (141.7 ± 310.4 mL). Among all patients, 44% were female and 56% were male. Post-procedural chest pain occurred in 9 patients (8.8%), predominantly in the blind group (88.8%) compared to the ultrasound-guided group (11.1%), showing statistical significance (p = 0.031). No pneumothorax was observed in either group, and minor complications such as hematoma and hemorrhage were reported only in the blind group. Conclusion: Real-time ultrasound-guided thoracentesis demonstrated superior safety and technical efficacy compared to the blind technique, allowing adequate fluid evacuation for both diagnostic and therapeutic purposes with minimal complications. Its accessibility, affordability, and reliability make it the preferred modality for managing both transudative and exudative pleural effusions in clinical practice.