PURPOSE: We have previously demonstrated that the anti-inflammatory drugs (corticosteroids or diclofenac) diminish the efficacy of pleurodesis induced by talc (TL) but not by silver nitrate (SN). In clinical practice, anti-inflammatory cyclooxygenase-2 inhibitors (COX-2) are used to control pain and inflammation. The aim of this study was to evaluate the influence of systemic COX2 (Parecoxib) in pleurodesis induced by TL or SN.
METHODS: Forty rabbits received intrapleural injection of 0.5% SN or 400 mg/kg TL. The first group (20 animals) received intramuscular injections of Parecoxib (1mg/Kg/day) during the first seven days, then one injection a week until the end of the study; the second group did not receive COX-2. After 1, 2, 7 or 28 days, five animals in each group were killed and macro and microscopic analyses were performed using scores from 0 to 4. Statistical analysis: t-test.
RESULTS: The systemic injection of COX-2 reduced the gross adhesions at the 2nd and 7th day only in the talc group (*p<0.05); however after 28 days no statistical difference was observed. Microscopic pleural inflammation decreased after 28 days in both groups (*p<0.05). No changes were observed in pleural fibrosis(Figure).
CONCLUSION: The systemic injection of Parecoxib did not interfere in the effectiveness of pleurodesis induced by silver nitrate or talc.
CLINICAL IMPLICATIONS: If these results can be extrapolated to clinical practice, anti-inflammatory cyclooxygenase-2 inhibitors (COX-2) may be used in patients submitted to pleurodesis.
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