Prevention of adhesions by sodium chromoglycate, dexamethasone, saline and aprotinin after pelvic surgery

Abstract

Background: The purpose of the present paper was to assess the efficacy of saline, sodium chromoglycate, dexamethasone and aprotinin, in single or in combined use in reducing postoperative pelvic adhesion formation in a rabbit model.

Methods: A standard lesion was performed to induce adhesion formation. Forty-five rabbits were divided into nine study groups. Group 1 was the non-treatment group. In group 2, 3 cm(3) of the rabbits' own serum was instilled i.p. In group 3, 5 mg/kg sodium chromoglycate and 3 cm(3) of the rabbits' own serum were administered i.p. The group 4 rabbits were instilled with 5 mg/kg sodium chromoglycate, 3 cm(3) rabbits' own serum and 1 mg/kg dexamethasone i.p. The group 5 rabbits were injected with 5000 units aprotinin i.m. 2 h before operation and 5 mg/kg sodium chromoglycate, 3 cm(3) of rabbit serum, 1 mg dexamethasone and 5000 units aprotinin instilled i.p. In group 6, 3 cm(3) saline was instilled i.p. Groups 7, 8 and 9 were a repeat of groups 4, 5 and 6 with the exception of replacement of the rabbit serum by 3 cm(3) saline. Animals were evaluated for adhesions 10 days after operation.

Results: Macroscopic adhesion scores of all the groups (2-9) were significantly less than scores of the control group (group 1). The macroscopic adhesion scores of group 9 and group 8 were significantly less compared to that of group 7.

Conclusion: Intraperitoneal instillation of saline and sodium chromoglycate decreased pelvic adhesion formation significantly in a rabbit model. Addition of aprotinin and dexamethasone to these agents gave a further advantage in decreasing pelvic adhesion formation.