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Effects of Lornoxicam on Anastomotic Healing: A Randomized, Blinded, Placebo-Control Experimental Study


Affiliations
1 2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
2 Department of Pathology, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
3 1st Department of Anesthesiology, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
4 2nd Department of Surgery, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
 

Introduction and Aim: With the implementation of multimodal analgesia regimens, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are often administered for optimal pain control and reduction of opioid use. The aim of the study was to examine the effects of lornoxicam, a NSAID, on anastomotic healing employing an animal model. Materials and Methods: A total of 28 Wistar rats were randomly assigned in two groups. All animals underwent ascending colonic transection followed by an end-to-end hand sewn anastomosis. Group 1 received intraperitoneally lornoxicambefore and daily after surgery. Group 2 received intraperitoneally an equal volume of placebo. Half of the animals in each group were euthanized on the 3rd pod and the remaining on the 7th pod. Macro- and microscopic indicators of anastomotic healing were compared using a two-tailed Fisher exact test. Results: The lornoxicam group significantly decreased fibroblast in growth and reepithelization of the mucosa at the anastomotic site on the 3rd pod and significantly increased occurrence of deep reaching defects, necrosis, and microabscess on the 7th pod. Conclusion: Lornoxicam administration during the perioperative period adversely affects histologic parameters of intestinal anastomotic healing. These effects of lornoxicam administration were not found to induce significant increase of anastomotic dehiscence in the rat model.
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  • Effects of Lornoxicam on Anastomotic Healing: A Randomized, Blinded, Placebo-Control Experimental Study

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Authors

Stamatoula Drakopoulou
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Elissaios Kontis
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Eirini Pantiora
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Antonios Vezakis
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Despoina Karandrea
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Eftychia Aravidou
2nd Department of Surgery, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Agathi Konti-Paphiti
Department of Pathology, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Erifili Argyra
1st Department of Anesthesiology, "Aretaieio" Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Dionisios Voros
2nd Department of Surgery, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Andreas A. Polydorou
2nd Department of Surgery, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece
Georgios P. Fragulidis
2nd Department of Surgery, “Aretaieio” Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece

Abstract


Introduction and Aim: With the implementation of multimodal analgesia regimens, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are often administered for optimal pain control and reduction of opioid use. The aim of the study was to examine the effects of lornoxicam, a NSAID, on anastomotic healing employing an animal model. Materials and Methods: A total of 28 Wistar rats were randomly assigned in two groups. All animals underwent ascending colonic transection followed by an end-to-end hand sewn anastomosis. Group 1 received intraperitoneally lornoxicambefore and daily after surgery. Group 2 received intraperitoneally an equal volume of placebo. Half of the animals in each group were euthanized on the 3rd pod and the remaining on the 7th pod. Macro- and microscopic indicators of anastomotic healing were compared using a two-tailed Fisher exact test. Results: The lornoxicam group significantly decreased fibroblast in growth and reepithelization of the mucosa at the anastomotic site on the 3rd pod and significantly increased occurrence of deep reaching defects, necrosis, and microabscess on the 7th pod. Conclusion: Lornoxicam administration during the perioperative period adversely affects histologic parameters of intestinal anastomotic healing. These effects of lornoxicam administration were not found to induce significant increase of anastomotic dehiscence in the rat model.