Reduction of postoperative adhesions by trimetazidine: an experimental study in a rat model

Trimetazidine (TMZ) reduces intracellular acidosis and inhibits oxygen-derived free radicals and neutrophile infiltration in ischemia and hypoxia, which are the primary steps of adhesion formation. Our aim is to study the anti-adhesion potential of trimetazidine in a rat uterine horn model.

Forty non-pregnant female Wistar-Albino rats were randomly assigned, with ten in each group, to receive 2 ml saline, or 5 mg/kg intraperitoneal trimetazidine postoperatively, and control and sham. TMZ was administered to TMZ postoperative group 5 mg/kg i.p. daily for 5 days after the operation. Both uterine horns were exposed, and then a 2 cm segment of the anti-mesenteric surface of both the uterine horns were traumatized in 10 spots with unipolar electrocautery for 2 s with a power of 50 Watts. All the animals were killed by lethal dose of ether on postoperative 14th day. Intraperitoneal adhesions were scored by clinical adhesion scoring system, and histological and morphometric analysis was performed.

Total adhesion score (TAS) of control group was 10 while the sham group was found to be 0. TAS of the placebo group that was given saline (TAS 5), and postoperative TMZ applied group (TAS 3.5) were significantly lower than the control group (p < 0.05). The severity scores of postoperative TMZ and sham groups were significantly smaller than the other groups (p < 0.05).

TMZ significantly reduced the extent and severity of horn adhesions. The promising efficacy demonstrated by the intraperitoneal TMZ in this model warrants further investigation in clinical trials focused on gynecological procedures.