Evaluation the effects of N-acetyl cysteine on pericardial adhesions in experimental rabbit models

Adhesions are one of the main causes of re-sternotomy complications. In this study, we evaluated the potential of N-acetyl cysteine irrigation in reducing or preventing pericardial adhesions after cardiac surgery in rabbits. Thirty rabbits were allocated randomly into two groups. Group C served as the control, and group N was the treatment group. After anaesthesia, sternotomy and opening a pericardial flap, the pericardial cavity was irrigated with 1 ml/kg saline (group C) or with 100 mg/kg of N-acetyl cysteine (group N). After 2 months, the sternum was re-opened and the site of operation evaluated for macroscopic and microscopic changes. Macroscopic evaluation revealed 40 % ( n = 6) with grade 1, 46 % ( n = 7) with grade 2, and 13.3 % ( n = 3) with grade 3 adhesions in group C. In group N, there were 60 % ( n = 9) with grade 0 (no adhesions) and 40 % ( n = 6) with grade 1 adhesions. N-acetyl cysteine irrigation appears to significantly reduce macroscopic adhesions, and there was also a trend towards a reduced reaction microscopically; therefore, further studies are warranted.