Low-Dose Aspirin to Prevent Postoperative Adhesion Formation in the Rabbit Model

Among the various agents used to prevent postoperative adhesion formation, nonsteroidal antiinflammatory drugs (NSAIDs) have recently gained wide attention because of the relative lack of side effects compared with traditional antiinflammatory agents, namely, corticosteroids. The inconsistency of data published in the literature for the adhesion prophylactic effect of NSAIDs could be related to the different compounds and dosage regimens. We evaluated the efficacy of intramuscular acetylsalycilic acid (ASA) administered perioperatively for 5 days in two regimens: low-dose (L-ASA) 1.7 mg/kg/day, and high-dose (H-ASA) 28.0 mg/kg/day, versus no perioperative treatment (controls) in 24 New Zealand white female rabbits undergoing conservative pelvic surgery in a randomized trial. At second look, the adhesion score was significantly lower in the L-ASA animals than in the H-ASA and control groups. The adhesion score in the H-ASA group was lower, although not significantly, than in the control group. We conclude that the inhibition of postoperative adhesion formation observed with L-ASA could be due to the selective inhibition of thromboxane A2 over prostacyclin.