Effects of Metoclopramide on Healing of Colonic Anastomoses in a Rat Model of Abdominal Sepsis

Abstract

ABSTRACTIntroduction: Metoclopramide is often used in the treatment of postoperative nausea and vomiting, but a literature review failed to find reports on the influence of this drug on the healing of bowel anastomoses in the setting of abdominal sepsis. The aim of this study was to evaluate the effects of metoclopramide on the healing of left colonic anastomoses in rats with induced abdominal sepsis. Materials and Methods: Forty rats were divided into two groups of 20 animals each to receive either metoclopramide (experimental group: E) or saline (control group: C). Each group was further divided into subgroups of 10 animals each to be killed on the third (E3 and C3) or seventh postoperative day (E7 and C7). A segmental resection of the left colon was performed, followed by end-to-end anastomosis. Sepsis was induced by cecal ligation and puncture. On the day of reoperation, the total number of adhesions was assessed and the anastomosed bowel segment was removed for tensile strength testing, histopathological analysis, measurement of hydroxyproline levels, and histomorphometric evaluation of collagen. Results: Intraoperative findings, number of intra-abdominal adhesions in the anastomosed area, and tensile strength before anastomosis rupture were similar among all subgroups at all assessments. On the third postoperative day, the anastomoses of animals treated with metoclopramide showed significantly lower hydroxyproline levels (p = 0.01) when compared with controls. Collagen content was similar among all subgroups. Conclusions: Metoclopramide does not have deleterious effects on the healing of bowel anastomoses in rats subjected to experimental abdominal sepsis.