[Prophylactic antithrombotic therapy after orthopedic surgery with bemiparin, a second-generation low molecular weight heparin].
OBJECTIVE
Bemiparin is a new second generation low molecular weight heparin with a molecular weight of 3,600 daltons and an anti-Xa/anti-IIa ratio greater than 8. The aim of this study was to evaluate the efficacy and safety of bemiparin administered at a daily dose of 3,500 IU anti-Xa (40 mg), with prophylaxis beginning 6 hours after total hip replacement surgery.


METHODS
Fifty-seven consecutive patients were evaluated by bilateral phlebography of the lower limbs 10 days after surgery. The patients were recruited at two centers specializing in orthopedic surgery.


RESULTS
The incidence of deep venous thrombosis (DVT) in the series was 7% (95% CI: 0.4-13.7). In three patients (5%) DVT was proximal (95% CI 0-11.1). These results are consistent with those reported by Kakkar for bemiparin at the same dose begun two hours before surgery (incidence of DVT: 7.2%). No episodes of major bleeding were observed with this new protocol for postoperative administration. The incidence of wound hematoma was low and no patient required further surgery. The rate of post-operative bleeding was similar to that usually reported when low molecular weight heparin is used in hip surgery.


CONCLUSIONS
Thromboprophylaxis in orthopaedic surgery with bemiparin beginning 6 hours after surgery appears to be safe and effective.
Planès
A
A
Clinique Radio-Chirurgicale du Mail, La Rochelle, Spain.
Vochelle
N
N
González De Suso
M J
MJ
Claracq
J P
JP
D019644:Arthroplasty, Replacement, Hip; D016001:Confidence Intervals; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; C411345:bemiparin