Postoperative adhesion prevention with low-dose aspirin: effect through the selective inhibition of thromboxane production.
The aim of the present study was to evaluate the efficacy of low-dose versus high-dose aspirin in the prevention of postoperative adhesion formation. Forty New Zealand White rabbits were randomized into three groups: low-dose aspirin (1.7 mg/kg per day for 5 days starting on the day of surgery), high-dose aspirin (28.0 mg/kg per day), and controls. The rabbits underwent a standardized surgical injury on the ovary, uterine horn and abdominal wall on one side at laparotomy. On postoperative day 21, a second-look laparotomy was performed for the evaluation of postoperative adhesions. In five animals in each group, peritoneal fluid samples were collected at initial surgery, then through an additional 2 cm incision performed on postoperative day 3, and at second-look laparotomy. The peritoneal concentrations of thromboxane B2 and 6-keto-prostaglandin F1alpha (the stable hydrolysis product of prostacyclin) were measured by radioimmunoassay. At second-look laparotomy, the adhesion formation rate was 46% in the low-dose aspirin group, 77% in the high-dose group, and 100% in the control group. The adhesion score in the low-dose group was significantly lower (P < 0.01) than in the high-dose and control groups. Peritoneal thromboxane decreased significantly during treatment in both low-dose and high-dose aspirin groups, whereas prostacyclin decreased only in the high-dose group. Postoperative adhesion reduction observed in this study with low-dose aspirin treatment could be due to the selective inhibition of thromboxane over prostacyclin production.
Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
L
L
Muzii
R
R
Marana
L
L
Brunetti
F
F
Margutti
M
M
Vacca
S
S
Mancuso
D000009:Abdominal Muscles / Q000601:surgery; D000818:Animals; D001241:Aspirin / Q000008:administration & dosage*; D005260:Female; D010053:Ovary / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D013927:Thrombosis / Q000517:prevention & control*; D013931:Thromboxanes / Q000037:antagonists & inhibitors*; D014599:Uterus / Q000601:surgery
D010975:Platelet Aggregation Inhibitors; D013931:Thromboxanes; D001241:Aspirin