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Calcium Channel Blockade Prevents Postsurgical Reformation of Adnexal Adhesions in Rabbits

From the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles; and the Department of Surgery, University of California, San Francisco School of Medicine, Fresno Medical Education Program, Fresno, California

Abstract

Prevention of postoperative adhesion formation is a subject of concern to the reproductive surgeon. We developed a model to test the efficacy of calcium channel blockademediated adhesion prophylaxis after lysis of established pelvic adhesive disease. New Zealand White rabbits received a standardized primary adhesiogenic traumatic lesion to the left uterine horn. One week later, a laparotomy was performed for evaluation (prescore scale: 0=no adhesions to 4+=severe) and subsequent lysis of adhesions. Before operative closure, animals were allocated randomly to intraperitoneal treatment with either verapamil 2.5 µg/kg/hour or vehicle, delivered by mini-osmotic infusion pumps over the course of 200 hours. Seven days later, the animals were sacrificed and evaluated blindly for extent of adhesion reformation (postscore). Prescores for verapamil and control rabbits were not significantly different (3.3 versus 2.9). Verapamil-treated animals formed considerably fewer adhesions than did controls after adhesiolysis (postscore 0.5 versus 3.5; P<.001). These data demonstrate a marked inhibition of adhesion reformation after lysis of pelvic adhesions under the influence of verapamil

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