A combination of heparin and an intermittent pneumatic compression device may be more effective to prevent deep-vein thrombosis in the lower extremities after laparoscopic cholecystectomy.
BACKGROUND
The purpose of this study was to clarify the effect of a combination of heparin and an intermittent pneumatic compression device on thrombogenesis and platelet activation in the upper and lower extremities after laparoscopy.


METHODS
A blinded study was performed on 30 patients. Patients were randomly injected with either heparin or physiological saline solution (PSS) subcutaneously. The intermittent compression boot was used during surgery. Plasma D-dimer (D-D), a marker of thrombogenesis, and b-thromboglobulin (b-TG), a marker of platelet activation, were measured in the upper and lower extremities.


RESULTS
In the heparin group, D-Ds in the upper and lower extremities increased significantly 24 h after surgery, but they were significantly lower than those of the PSS group. b-TG in the lower extremities of patients in the PSS group increased significantly 24 h after surgery.


CONCLUSIONS
A combination of low-molecular-weight heparin and intermittent pneumatic compression may be more effective to prevent deep-vein thrombosis in the legs.
Okuda
Y
Y
Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan. y-okuda@dokkyomed.ac.jp
Kitajima
T
T
Egawa
H
H
Hamaguchi
S
S
Yamaguchi
S
S
Yamazaki
H
H
Ido
K
K
D000328:Adult; D000367:Age Factors; D000758:Anesthesia / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005676:Gravity Suits; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D007866:Leg / Q000098:blood supply*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012737:Sex Factors; D013997:Time Factors; D020246:Venous Thrombosis / Q000517:prevention & control*
D006493:Heparin