it is a painful procedure. So enough analgesics and local analgesia required:

• 5 mg Oramorph 30 mins before procedure
• 20 ml of 2% Lignocaine 20 mins before
• Flush with 20 ml of Normal saline
• Wait 15 mins
• put 2 g of Talc (rate is not to fast /not too slow.. for about 1 min time)
• Flush with 20 ml of N.saline
• Clamp for 2 hours
• Unclamp and leave over night
• Remove the chest drain next morning.

Issue in this procedure is pain control.

In some hospitals, they do not give oramorph.

Need to follow hospital/local guide line

yes, there is a slight variation.

Here is BTS (British thoracic society) guide line

Update: 15/05/2010

Some centres have tried 100ml 0f autologous blood instead of Talc or Tetracycline. But still needs more RCT.

Blood pleurodesis for the medical management of pneumothorax