Postoperative adhesion prevention with low-dose aspirin: effect through the selective inhibition of thromboxane production

Hum Reprod. 1998 Jun;13(6):1486-9. doi: 10.1093/humrep/13.6.1486.

Abstract

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.

MeSH terms

  • Abdominal Muscles / surgery
  • Animals
  • Aspirin / administration & dosage*
  • Female
  • Ovary / surgery
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Postoperative Complications / prevention & control*
  • Rabbits
  • Thrombosis / prevention & control*
  • Thromboxanes / antagonists & inhibitors*
  • Uterus / surgery

Substances

  • Platelet Aggregation Inhibitors
  • Thromboxanes
  • Aspirin