title: Perioperative pain relief by a COX-2 inhibitor affects ileal repair and provides a model for anastomotic leakage in the intestine.
abstract: The authors examined the potential of the cyclooxygenase 2 (COX-2) inhibitor carprofen to reproducibly induce anastomotic leakage. In experiment 1, an anastomosis was constructed in both ileum and colon of 20 rats, and they were given carprofen (5 mg/kg subcutaneously every 24 hours) or buprenorphine (0.02 mg/kg subcutaneously every 12 hours). In another 20 rats an anastomosis was constructed in either ileum or colon, and all received carprofen (experiment 2). Animals were sacrificed after 3 days. In experiment 1, the ileal dehiscence rate was 60% in the carprofen group and 0% in the buprenorphine group (P = .0108). Colonic anastomoses in both groups remained patent. In experiment 2, the anastomotic leakage rate was 80% in ileum and 0% in colon. Thus, COX-2 inhibitors can severely interfere with intestinal healing, particularly in the ileum. Perioperative administration of carprofen yields a unique model for anastomotic leakage, which allows translational research on the effectiveness of perisuture line reinforcement.
authors.affiliation: Department of Surgery, Radboud University, Nijmegen, The Netherlands. r.vandervijver@chir.umcn.nl
authors.forename: R J
authors.initials: RJ
authors.lastname: van der Vijver
authors.forename: C J H M
authors.initials: CJ
authors.lastname: van Laarhoven
authors.forename: B M
authors.initials: BM
authors.lastname: de Man
authors.forename: R M L M
authors.initials: RM
authors.lastname: Lomme
authors.forename: T
authors.initials: T
authors.lastname: Hendriks
mesh_terms: D000701:Analgesics, Opioid / Q000494:pharmacology; D057868:Anastomotic Leak / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D000818:Animals; D002047:Buprenorphine / Q000494:pharmacology; D002227:Carbazoles / Q000009:adverse effects / Q000494:pharmacology*; D003094:Collagen / Q000378:metabolism; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D004195:Disease Models, Animal; D007082:Ileum / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D010146:Pain / Q000188:drug therapy*; D059035:Perioperative Period; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D013529:Surgical Wound Dehiscence / Q000139:chemically induced*; D015431:Weight Loss / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D002227:Carbazoles; D052246:Cyclooxygenase 2 Inhibitors; D002047:Buprenorphine; D003094:Collagen; D020778:Matrix Metalloproteinase 2; C522363:Mmp2 protein, rat; C007005:carprofen