Intraperitoneal lidocaine hydrochloride for prevention of intraperitoneal adhesions following laparoscopic genitourinary tract surgery in ewes

Abstract

Adhesion formation involving the genitourinary tract is common following laparoscopic procedures. To evaluate the effectiveness of intraperitoneal lidocaine hydrochloride 1% solution for the prevention of abdominal adhesions, twenty four Santa Ines ewes submitted to laparoscopic ovum pick-up, uterine puncture and local rinsing, were randomly distributed into two groups of 12 animals, according to rinsing solution: normal saline (SG) or 1% lidocaine hydrochloride solution (LG). Laparoscopy for manipulation of the reproductive tract (uterine puncture trauma model and ovum pick-up) was applied. A standard laparoscopic approach using three ports in triangulation was employed. The uterus and ovaries were rinsed at the end of the procedure (using either saline or lidocaine hydrochloride) for removal of blood clots from the ovaries and uterine horn surfaces. Inflammation was assessed postoperatively by plasma fibrinogen, and all animals underwent a second laparoscopic procedure 21days after surgery for macroscopic assessment of adhesion formation. Four cases of adhesion were observed in each group. The plasma fibrinogen did not differ between groups and among different time points, indicating an absence of systemic inflammation following laparoscopic procedures. There were no significant differences between treatments. Both normal saline and 1% lidocaine hydrochloride were similarly effective in the prevention of adhesion formation.