The effectiveness of local anesthetics in preventing postoperative adhesions in rat models

Abstract

Intra-abdominal adhesions are fibrous bands that develop after abdominal surgery or inflammation and cause significant surgical morbidity and mortality. In this study, the effectiveness of lidocaine, prilocaine and bupivacaine in preventing experimental intra-abdominal adhesions in rats was studied. After obtaining the approval of our local institutional review board, 50 female Wistar-Albino rats weighing 250-320g underwent laparotomy via a standard 5-cm midline incision under intramuscular anesthesia with ketamine (40mg/kg) and xylazine (10mg/kg). The cecal serosa and adjacent abdominal wall were superficially injured using sterile gauze. The laparotomy incision was closed after irrigation of the peritoneal cavity with the following: 5ml saline in Group II, (the sham group), 7mg/kg prilocaine in Group III, 3mg/kg lidocaine in Group IV or 2mg/kg bupivacaine in Group V. No irrigation was performed in Group I rats (the control group). After laparotomy closure, all rats were allowed to wake spontaneously. Two weeks after the initial experimental procedure, all rats underwent a second laparotomy, and adhesions were scored using the Linsky scale. The adhesion quantity and quality were comparable among all groups (P>0.05); however, adhesion severity scores were significantly lower in the prilocaine and bupivacaine groups vs. the other groups (P<0.05). Prilocaine and bupivacaine were found to decrease the severity of intra-peritoneal adhesions.