The effect of addition of dexamethasone into normal saline irrigation solution on Prevention of Intraperitoneal Adhesion Post Laparotomy in wistar rats (Rattus norvegicus)

INTRODUCTION: Intraperitoneal adhesion is a pathological condition of adhesion between the omentum, intestine and abdominal wall. The purpose of this study was to determine the effect of adding dexamethasone into normal saline fluid to prevent intra peritoneal adhesion. MATERIALS AND METHODS: This study used experimental post-test only control group design. There were four treatment groups using six white rats in each group: group I without administration of normal saline and dexamethasone, group II with administration of normal saline irrigation, group III by adding dexamethasone dose 0.2 mg/BW into 5 cc normal saline, and group IV by adding 0.5 mg/BW into 5 cc normal saline. Laparotomy was performed to all samples followed by excoriation and abrasion in cecum and terminal ileum using gauze. Intra peritoneal adhesion assessment was carried out on the 10th day post laparotomy. Macroscopic and microscopic assessments were performed to evaluate formation of collagen, fibrin and the spread of inflammatory cells of each group. RESULTS: From macroscopic observations, it was found that the average adhesion that occurred was 3.333; 2.333; 0.666; 0.333 by using statistical calculations with one-way ANOVA with P value of 0.000. Post-Hoc analysis showed that the administration of dexamethasone 0.5 mg/BW is proven to minimize the occurrence of adhesion between the 3 groups. Microscopic assessment of the formation of collagen, fibrin and the spread of inflammatory cells by one-way ANOVA produced P 0.000 in all three parameters, but the dose of dexamethasone administration between 0.2 mg/BW and 0.5 kg/BW did not prove significant in either group. CONCLUSION: There is evidence that the addition of dexamethasone to normal saline as an irrigation liquid during laparotomy can reduce the occurrence of adhesion. However, the dose difference was not proven to be better in this study. Further studies are suggested to use more experimental animals.