Draw up to 6-8 cc's of 2% xylocaine. Raise a wheel in the skin over the lower rib of the selected interspace. Infiltrate a few cc's of anesthetic subcutaneously. Always be sure to withdraw the needle to make sure no blood returns. You do not want to inject the anesthetic into a vein. Once you reach the patient's rib, inject a few cc's to anesthetize the periosteum.
Aim the needle towards the upper margin of the patient's rib and anesthetize the parietal pleura. Advance the needle gently and carefully withdraw it. If fluid returns, do not aspirate too much fluid, as it will dilute the anesthetic. Gently withdraw the needle until no further fluid returns. That should place you on the outer surface of the parietal pleura. Inject a few cc's to anesthetize the pleura.
