The usual site for insertion of the thoracentesis needle is the posteriolateral aspect of the back over the diaphragm, but under the fluid level. Confirm site by counting the ribs based on chest x-ray and percussing out the fluid level.Click to see full answer. Moreover, where does a thoracentesis needle go?Be sure to insert the thoracentesis needle just above the upper edge of the rib and not below the rib, to avoid the intercostal blood vessels and nerves at the lower edge of each rib. what intercostal space is used for thoracentesis? The thoracentesis site should be in the mid scapular or posterior axillary line (6-10 cm lateral to spine), and one to two intercostal spaces below the highest level of the effusion. Accordingly, how do you perform a pleural puncture? Insert the needle along the upper border of the rib while aspirating and advance it into the effusion. When fluid or blood is aspirated, insert the catheter over the needle into the pleural space and withdraw the needle, leaving the catheter in the pleural space.How painful is a thoracentesis?You may feel discomfort or pain in your shoulder or the area where the needle was inserted. This might happen toward the end of your procedure. It should go away when the procedure is finished, and you shouldn’t need medication for it. Let your doctor know if you feel a lot of pain and they may pause the procedure.