[Prevention of deep vein thrombosis (DVT) with the low molecular weight heparin (LMWH) and epidural/spinal anesthesia. The efficacy viewpoint].

OBJECTIVES

To compare the frequency of DVT and PE (pulmonary embolism) events in patients who had undergone gynecological operations under epidural/spinal anaesthesia without LMWH prophylaxis with patients receiving LMWH prophylaxis.

DESIGN

Retrospective, hospital record based study.

MATERIALS AND

METHODS

The majority of patients had undergone vaginal operations. 441 consecutive, unselected patients without LMWH prophylaxis vs. 463 ones treated with LMWH. The patients were given Fraxiparine a 7,500 ICU s.c. 2 h before operation. The same doses were repeated every 24 h during 5-7 days or to the regaining by the patient sufficient physical activity. DVT diagnosis was based on the clinical signs and ultrasound techniques. PE was stated on clinical symptoms, ECG chest x-ray characteristics and gasometric data.

RESULTS

Among the patients without LMWH prophylaxis 2 cases of PE occurred (0.45%), one of these was fatal. 1 case of proximal DVT (0.23%) and 3 distal DVT complications (0.68%) were stated. In the LMWH group 1 proximal DVT (0.22%) and 2 distal DVT (0.43%) developed.

CONCLUSIONS

Perioperative LMWH prevention proved to be efficient. The clinically expressed incidence of DVT expressively diminished: 8 cases-(1.66%) vs. 3 cases-(0.53%). The pulmonary embolism was avoided.