Noncompliance in the inpatient administration of enoxaparin in conjunction with epidural or spinal anesthesia

Deep venous thrombosis is 1 of the most common postoperative complications resulting in significant mortality and morbidity in patients undergoing total hip and total knee arthroplasty. Research has shown that the effectiveness and safety of low-molecular-weight heparins depend on the timeliness of their administration, particularly when used in conjunction with spinal or epidural anesthesia, both of which are effective and safe treatment modalities for knee and hip arthroplasty. The focus of this study was to examine the compliance with current protocols in the administration of enoxaparin (Lovenox) to patients who had undergone total joint arthroplasty. We reviewed the perioperative management of patients who had a total hip or total knee arthroplasty in which there was the combined use of epidural or spinal anesthesia and enoxaparin. Our results show a 52% (26 of 50) noncompliance rate in the administration of enoxaparin as compared with the published protocol for using this treatment modality safely and effectively.