Compare the efficacy of cosmetic talc with that of iodopovidone as an agent for chemical pleurodesis

Basanta hazarika., Chandan Matage., Jogesh Sarma and Sharma, K.R

Backgound: Chemical pleurodesis is accepted palliative therapy for patients with recurrent, symptomatic malignant pleural effusions. For benign effusions or pneumothorax the aim is to avoid recurrences rather than palliation. A wide variety of agents have been used for pleurodesis. Cosmetic talc and iodopovidone are two inexpensive and easily available agents. There is paucity of data on the comparative efficacy of these two. So, the aim of the study is to compare the efficacy of cosmetic talc with that of iodopovidone, as agents for chemical pleurodesis.

Methods: It was a hospital based observational study. Patients requiring pleurodesis were openly randomized to two groups. Iodopovidone- 30 ml was used after dilution with 20 ml normal saline for the first group, and cosmetic talc 5 g was used after being autoclaved and made as slurry mixed with 50ml of saline and instilled by tube thoracostomy.

Results: A total of 60 patients were included in the study. Out of the 60 patients enrolled in the study, the clinical indication for pleurodesis was pleural effusion in 38(63.4%) patients and pneumothorax in 22 (36.6%) patients. The success rate of pleurodesis with iodopovidone in patients with pneumothorax was 92.3% with failure rate was 7.7% and success rate of talc pleurodesis was 88.9% with failure rate was 11.1%. On the other hand the success rate for Iodopovidone pleurodesis in patients with pleural effusion was 90.5% with failure rate was 9.5% and the success rate for talc pleurodesis in pleural effusion was 94.1% with failure rate was 5.9%. Overall success rates for the two agents were comparable at 92.3% and 91.2% for talc and iodopovidone respectively, without any statistically significant difference between the two groups (p-0.875).

Conclusion: The results of the present study suggest that both iodopovidone and cosmetic talc are equally effective when instilled by tube thoracostomy. Both the agents demonstrated a good safety profile in treating recurrent pleural effusions and pneumothorax with a good success rate and few minor complications.

Download PDF: