Effects of diclofenac sodium on bursting pressures of anastomoses and hydroxyproline contents of perianastomotic tissues in a laboratory study

Abstract

Background: Non-steroidal anti-inflammatory drugs are commonly used to relieve postoperative pain. Diclofenac sodium is a non-steroidal anti-inflammatory drug used as an analgesic during the postoperative period. Diclofenac sodium has powerful anti-inflammatory actions. As anti-inflammatory action may interfere with wound healing, we have studied the effects of diclofenac sodium on the healing of colonic anastomosis in rats.

Methods: Thirty-six Sprague-Dawley rats were used. Resection and anastomosis was performed on the distal colon of rats. The diclofenac group of rats received 4mg/kg/day diclofenac sodium intramuscularly. The control group received 0.1mL/day 0.9% NaCl intramuscularly. Anastomoses were evaluated with bursting pressure of the anastomoses and hydroxyproline level of the perianastomotic tissues on the third and seventh postoperative days. The Mann-Whitney U-test was used for statistical analysis.

Results: Three rats from each group died because of septic complications due to anastomotic leaks. Bursting pressures of the diclofenac group of rats (3rd day: 40.12+/-6.72mmHg; 7th day: 172.02+/-30.74mmHg) were lower than controls (3rd day: 54.13+/-8.11mmHg; 7th day: 206.00+/-27.14mmHg) both on the third and seventh days. Mean hydroxyproline contents of the perianastomotic tissues of diclofenac-treated rats (3rd day: 1.97+/-0.17mug/mg tissue; 7th day: 3.61+/-0.32mug/mg tissue) were lower than controls (3rd day: 2.16+/-0.12mug/mg tissue; 7th day: 4.95+/-0.64mug/mg tissue) both on the 3rd and 7th days, similar to bursting pressures.

Conclusions: Diclofenac sodium had a negative effect on bursting pressures of the colonic anastomoses and hydroxyproline contents of perianastomotic tissues of rats in our study. Anastomotic leak rates were not affected. The effects of diclofenac sodium should be studied in detail.