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COX-2 inhibitors, known best for treating arthritis pain, recently came under scrutiny with evidence that chronic use may increase risk of heart attack and stroke. But a discovery at
Children's Hospital Boston suggests that short-term use of one COX-2 inhibitor, Celebrex, is potentially of great value to surgical patients.
Surgeons Mark Puder, MD, PhD, and Arin Greene, MD, found that Celebrex prevents surgical adhesion formation in mice. Adhesions—bands of scar tissue that join two separate internal body surfaces—develop in 55 to 90 percent of patients undergoing surgery, depending on the procedure. A natural occurrence as the body heals, adhesions can cause significant complications (bowel obstructions after stomach surgery, for example) when surfaces join that normally would not. Repeat surgery to cut through them is often needed, and they frequently recur.
In the Children's study, which appeared in the March issue of Annals of Surgery, mice that received Celebrex for 10 days after abdominal surgery were much less likely to have adhesions at 10 and 35 days post-surgery than mice given either a placebo or a non-selective COX inhibitor, like ibuprofen or aspirin. Six of the 11 Celebrex-treated mice were completely adhesion-free. Based on these findings, Puder is now planning a multi-institutional clinical trial of Celebrex in adult surgical patients.