Effects of Carbon Dioxide-Saturated Normal Saline and Ringer's Lactate on Postsurgical Adhesion Formation in the Rabbit

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Abstract

Objective:

To evaluate the effect of combining carbon dioxide gas (CO2) with normal saline versus CO2 with lactated Ringer's solution on adhesion formation in the rabbit model.

Methods:

Sixty New Zealand white rabbits underwent surgery based on a proven experimental adhesion model. Following abdominal closure, the animals were randomly assigned to three groups: Group 1 underwent abdominal CO2 insufflation only; group 2 underwent abdominal irrigation with CO2-saturated normal saline; group 3 underwent abdominal irrigation with CO2-saturated lactated Ringer's solution. Three weeks later, the rabbits were sacrificed and the adhesions were scored in a blinded fashion based on the extent, type, and tenacity, with a maximum possible score of 11.

Results:

The mean (± standard deviation) adhesion scores were 7.75 ± 2.82 in group 1, 7.85 ± 2.58 in group 2, and 4.75 ± 2.95 in group 3. There was no difference in severity of adhesions between groups 1 and 2. However, the mean adhesion score was significantly lower in group 3 (lactated Ringer's with CO2) than in either group 1 (CO2) or group 2 normal saline with CO2) (P = .004 and P = .002, respectively).

Conclusion:

It appears that when CO2 is the insufflating gas, lactated Ringer's solution has a protective effect against adhesion formation in the rabbit model.

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