<![CDATA[Background: Pleural puncture (thoracentesis) often causes anxiety, stress, and pain. Although 2% lidocaine is commonly used for analgesia, its effect on psychological distress is limited. Acupressure may help reduce both pain and emotional discomfort. This study evaluated the effectiveness of 2% lidocaine combined with acupressure in patients undergoing pleural puncture. Subjects and Method: A randomized controlled trial was conducted on 36 patients undergoing pleural puncture at Dr. Moewardi Regional General Hospital, Surakarta, Indonesia. Patients were allocated to three groups: Control (2% lidocaine 4 cc), Treatment 1 (2% lidocaine 4 cc + acupressure), and Treatment 2 (2% lidocaine 2 cc + acupressure). Acupressure was applied 20 minutes prior to the procedure at points PC6, Yintang (EX-HN3), Hegu (LI4), and Baihui (GV20). Anxiety, stress, and pain were assessed using DASS-21 and Numeric Rating Scale (NRS) before and after the procedure. Data were analyzed using Shapiro-Wilk normality test, Levene homogeneity test, ANOVA, paired t-test, and post hoc LSD test. Results: Anxiety scores were lower in treatment 1 (Mean=5.66; SD=2.38) and treatment 2 (Mean= 5.16; SD=2.48) than in the control group (Mean=8.00; SD=3.07; p=0.009). Stress scores were also lower in treatment 1 (Mean=4.50; SD=2.27) and treatment 2 (Mean=4.33; SD=2.53) versus control (Mean=7.16; SD=3.01; p=0.001). Pain scores were reduced in treatment 1 (Mean=1.50; SD=1.31) and treatment 2 (Mean=1.33; SD=0.88) compared with control (Mean=2.91; SD=1.67; p=0.036). No significant differences were found between treatment groups (p>0.05). Conclusion: Acupressure combined with 2% lidocaine effectively reduces anxiety, stress, and pain during pleural puncture. Lower-dose lidocaine provided comparable outcomes when combined with acupressure.]]>
