T. Guvenal et al., Prevention of postoperative adhesion formation in rat uterine horn model by nimesulide: a selective COX-2 inhibitor, HUM REPR, 16(8), 2001, pp. 1732-1735
BACKGROUND: Pelvic surgery is one of the main causes of intraperitoneal (i.
p.) adhesions that create various medical problems including pelvic pain, b
owel obstructions and female infertility. A rat model was used to investiga
te the efficacy of nimesulide, a selective cyclooxygenase-2 inhibitor, in t
he prevention of adhesion formation. METHODS: Fifty Wistar-Albino rats unde
rwent bilateral uterine horn injury with a unipolar cautery. Study groups w
ere as follows: (i) control group, no adjuvant therapy; (ii) i.p. Ringer's
lactate group, 2 ml Ringer's lactate solution was instilled i.p.; (iii) i.p
. Ringer's lactate plus nimesulide group, I ml Ringer's lactate plus 1 ml n
imesulide (0.5 mg/ml) were given i.p.; (iv) intramuscular (i.m.) nimesulide
group, 1 ml i.m. nimesulide (0.5 mg/ml) was given preoperatively for 5 day
s; and (v) i.p. nimesulide group, 1 ml nimesulide (0.5 mg/ml) was instilled
i.p. At the end of the study all animals were killed, and a standard adhes
ion scoring system was applied by a blinded examiner. RESULTS: The mean adh
esion extent in study groups was as follows: 1.33 +/- 0.76 in control group
, 1.40 +/- 0.90 in i.p. Ringer's lactate group, 0.75 +/- 0.70 in i.p. Ringe
r's lactate plus nimesulide group, 0.25 +/- 0.44 in i.m. nimesulide group a
nd 0.31 +/- 0.70 in i.p. nimesulide group. The mean +/- SD adhesion severit
ies of control, i.p. Ringer's lactate, i.p. Ringer's lactate plus nimesulid
e, i.m. nimesulide, and i.p. nimesulide groups were 0.58 +/- 0.35, 0.30 +/-
0.41, 0.27 +/- 0.3, 0.12 +/- 0.28 and 0.15 +/- 0.35 respectively. The lowe
st adhesions were found in the groups treated with nimesulide i.m. and nime
sulide i.p. (P < 0.05). CONCLUSIONS: This study showed that preoperative i.
m. or postoperative i.p. administration of nimesulide to the site of injury
reduced the formation of postoperative adhesions in a rat uterine horn mod
el.