The safety and efficacy of intraoperative heparin in total hip arthroplasty.
A single dose of unfractionated heparin (15 U/kg), administered intravenously before surgery on the femur suppresses thrombogenesis during total hip replacement. Nine hundred eighty-nine patients (1021 hips) who received one dose of intraoperative heparin with hypotensive epidural anesthesia were followed up prospectively for 3 months. Asymptomatic deep vein thrombosis assessed by ultrasound in the first 198 consecutive patients showed an incidence of 7.1% (14 of 198). The incidence of clinical deep vein thrombosis in the subsequent 791 patients was 0.88% (seven of 791). Symptomatic pulmonary embolism occurred in 0.5% (five of 989). No patients died and there was one major bleeding episode. Based on this favorable experience, intraoperative heparin appears safe and efficacious as thromboembolic prophylaxis.
DiGiovanni
C W
CW
Department of Orthopaedic Surgery, The Hospital for Special Surgery, New York, NY 10021, USA.
Restrepo
A
A
González Della Valle
A G
AG
Sharrock
N E
NE
McCabe
J P
JP
Sculco
T P
TP
Pellicci
P M
PM
Salvati
E A
EA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007275:Injections, Intravenous; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000517:prevention & control; D020246:Venous Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D006493:Heparin