Low molecular weight heparin associated with spinal anaesthesia and gradual compression stockings in total hip replacement surgery |
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| Authors: | Samama, C. M. Clergue, F. Barre, J. Montefiore, A. Ill, P. Samii, K. The Arar Study, Group. |
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| Affiliation: | Department of Anaesthesiology and Critical Care, La Pitie Salpetriere, Paris, France; Department of Anaesthesiology and Critical Care, Tenon Hospital, Paris, France; Department of Anaesthesiology and Critical Care, Robert Debre Hospital, Reims, France; Cardiovascular Department, Bellon-Rhone-Poulenc Rorer, Neuilly-sur-Seine, France; Department of Anaesthesiology and Critical Care, Le Kremlin Bicetre Hospital, Le Kremlin Bicetre, France; ARAR (Association pour la Recherche en Anesthesie Reanimation) STUDY GROUP |
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| Abstract: | The benefit/risk ratio of administering heparin during spinal anaesthesiain patients undergoing total hip replacement (THR) has not been studiedwidely. We conducted a prospective, randomized, double- blind study tocompare low molecular weight heparin (LMWH) for 10 days and placebo inpatients undergoing THR performed under spinal anaesthesia associated withgradual compression stockings. Efficacy was assessed by systematicbilateral ascending venography on day 10 +/- 2 in a sequential analysis.Among the 170 patients enrolled, data were available in 153 patients. Inthe LMWH group (n = 78) the total incidence of deep vein thrombosis (DVT)was 14.1% compared with 37.3% in the placebo group (n = 75) (P = 0.0016).No gross neurological sequelae were observed during the study. This studyshowed that the addition of LMWH in patients undergoing THR under spinalanaesthesia and wearing gradual compression stockings significantlydecreased the incidence of venogram-proved DVT. |
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