Role of Subcutaneous Adrenaline in Reducing Bleeding Risks During Chest Drain Insertion in High-Risk Patients: A Case Report.

The vasoconstrictive effect of adrenaline combined with lidocaine is well-documented, but its efficacy in reducing procedure-related bleeding during chest drain insertion in coagulopathic patients remains unreported. We present the case of a 37-year-old male with alcohol-related decompensated liver cirrhosis (Child-Pugh C), thrombocytopenia (23,000 × 10⁹/L), and elevated INR (2.3), who developed a spontaneous right hydropneumothorax secondary to cavitary pneumonia. Despite profound coagulopathy, a lifesaving 18F Seldinger chest drain was inserted using adrenaline-lidocaine (1:200,000) for local anesthesia, achieving immediate hemostasis with no periprocedural bleeding. This highlights the potential role of adrenaline in mitigating bleeding risks during invasive procedures in high-risk patients.