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

Objective: 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.

Methods: Retrospective, hospital record based study. 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.