Prolonged leakage of ascitic fluid through the needle puncture site Infection (eg, due to contamination by the needle or skin flora) Bowel perforation, resulting in leakage of bowel contents into the peritoneum and infection of the ascitic fluid With large-volume paracentesis, hypotension and possibly transient hyponatremia and increased creatinine Equipment for Paracentesis Signed consent form Local anesthetic (eg, 10 mL of 1% lidocaine), 25 - and 20 - to 22-gauge needles, and 10-mL syringe Antiseptic solution with applicators, drapes, and gloves Sterile gauze sponges Paracentesis needle, such as an 18 - to 22-gauge (1.5-inch or 3.5-inch as needed) needle for diagnostic paracentesis, an 18 - to 14-gauge (1.5-inch or 3.5-inch as needed) or a 15-gauge (3.25-inch) Caldwell needle with overlying metal catheter for therapeutic paracentesis #11 scalpel blade (may be needed to widen the entry site, particularly for large-volume paracentesis and larger needles) 3-way stopcock 30 - to 50-mL syringe Wound dressing materials (eg, adhesive bandages) Appropriate containers (eg, red top and purple top tubes, blood culture bottles) for collection of fluid for laboratory tests For removal of large volumes, vacuum bottles or collection bags If ultrasound guidance is used, ultrasonographic equipment Additional Considerations for Paracentesis Colloid replacement, such as concurrent infusion of IV albumin (6 to 8 g / L of ascitic fluid removed or 50 g) or dextran - 70 (which has no infection risk), is sometimes recommended during large-volume paracentesis (eg, removal of > 5 L) to help avoid significant intravascular volume shift and post-procedure hypotension.