[Enoxaparin in the prevention of deep venous thrombosis in general surgery].
Because of their pharmacologic advantages Low Molecular Weight Heparins (LMWH) are more and more used in the prevention of deep venous thromboembolic disease. Among LMWH, enoxaparin (Lovenox Pharmuka) efficacy has been assessed in several clinical trials since 1986, including more than 10,000 patients. Two of them were carried out in patients undergoing general surgery. The first one was performed in 1988 by M Samama et al on about 800 patients which concluded that enoxaparin (in one 20 mg daily s.c. injection) was at least as effective as standard prophylaxis with Unfractionated Heparin (U H), (three 5,000 IU daily s.c. injections). Second trial, coordinated by S Haas in 1988 on more than 8000 patients confirmed safety and efficacy of enoxaparin in prevention of post-operative thrombosis. These trials corroborate those carried out in orthopaedic surgery with enoxaparin: efficacy at least as effective as UH, with only one daily s.c. injection; mild biologic follow up (particularly, coagulation tests are useless with usual doses); a same dosage for all patients (20 mg daily s.c. injection in general surgery and 40 mg daily in orthopaedic surgery) independent of patient's weight. This prescription has to be started 12 hours before surgery with 40 mg and 2 h before with 20 mg.
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D005340:Fibrinogen; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D010690:Phlebography; D011183:Postoperative Complications / Q000517:prevention & control*; D013927:Thrombosis / Q000517:prevention & control*
D006495:Heparin, Low-Molecular-Weight; D005340:Fibrinogen
L'énoxaparine dans la prévention des thromboses veineuses profondes en chirurgie générale.