The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats

NSAIDs have dual roles of providing analgesia and promoting healing. This study investigated the effects of 3 different NSAIDs on healing of colonic anastomosis in rats. The aim is to provide an evidence-based rationale for choice of postoperative analgesic agent in surgical patients who undergo this procedure. Forty-eight Sprague-Dawley conventional rats were separated into 4 groups of 12 rats, with one group as control, and the other groups receiving tenoxicam, metamizole, or diclofenac, respectively. Each group was subdivided into 2 subgroups according to sacrifice on postoperative day 3 or 7. Anastomotic healing was assessed by 3 parameters: (1) physical evaluation (bursting pressure), (2) histological evaluation (fibrotic index), and (3) biochemical evaluation (tissue hydroxyproline levels). Diclofenac had a negative effect on bursting pressures. Tenoxicam significantly increased the fibrotic index at day 7. Metamizole increased tissue hydroxyproline levels at day 3, but there was no significant difference between control and NSAID groups at day 7. Each drug showed benefits and drawbacks. Because tenoxicam promoted fibrosis, and metamizole increased collagen synthesis, with both agents showing few disadvantages, these 2 agents are recommended above diclofenac for promoting healing.