Prevention of postoperative adhesion formation in rat uterine horn model by nimesulide: a selective COX-2 inhibitor

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.