Talc powder vs doxycycline in the control of malignant pleural effusion: a prospective, randomized trial
Jarosław Kużdżał, Krzysztof Sładek, Dariusz Wąsowski, Jerzy Soja, Artur Szlubowski, Agnieszka Reifland, Marcin Zieliński, Andrzej Szczeklik
Med Sci Monit 2003; 9(6): PI54-59
Background:Various tubes have been advocated to deal with airway problems related to operative laryngoscopy. These include large- and small-diameter tubes localized in the supraglottic, subglottic, or transtracheal region.Material/Methods:We report our clinical experience with the use of the Benjet tube on 25 patients (23–64 years of age), American Society of Anesthesiologists physical status I and II, who underwent operative laryngoscopy. The Benjet tube was positioned within the trachea using a standard curved laryngoscope. Its proximal end was connected to a jet-ventilation system equipped with a pressure-limiting drive and airway-pressure gauge. A rigid microlaryngoscope was inserted, through which a sampling needle was introduced into the vicinity of the tracheal opening, for end-tidal carbon dioxide determination. Heart rate, non-invasive blood pressure, and hemoglobin oxygen saturation were continuously monitored.Results:The Benjet tube was found to be easy to introduce and remove and was unobtrusive in the larynx and trachea, allowing excellent surgical conditions. Cardiorespiratory parameters were stable and did not change from baseline values. End-tidal carbon dioxide values ranged between 34 and 35 mm Hg.Conclusions:We conclude that the Benjet tube is highly indicated for operative laryngoscopic procedures.Background:Malignant pleural effusion is a common problem in advanced cancers, contributing to the poor quality of life in this group of patients. The aim of the study was to assess the efficiency of talc powder and doxycycline in pleurodesis in patients with malignant pleural effusion in comparable conditions.Material/Methods:Of 52 patients screened, 33 entered the trial. They were randomized to the talc group (n=18) and the doxycycline group (n=15). Both groups were comparable with regard to age, sex and the most important variables influencing effectiveness of the procedure, i.e. primary malignancy and stage of metastatic involvement of the pleura. Efficiency of pleurodesis was prospectively assessed.Conclusions:Talc powder is superior to doxycycline in achieving pleurodesis in patients with malignant pleural effusion, in both short- and long-term observations.
Keywords: Adult, Aged, Anti-Bacterial Agents - therapeutic use, Breast Neoplasms - complications, Breast Neoplasms - parasitology, Doxycycline - therapeutic use, Female, Humans, Lung Neoplasms - complications, Lung Neoplasms - pathology, Male, Middle Aged, Neoplasm Metastasis, Neoplasms, Unknown Primary - complications, Neoplasms, Unknown Primary - parasitology, Pleural Effusion, Malignant - prevention & control, Talc - therapeutic use, Treatment Outcome