title: [Safety and economics of fondaparinux administration in the laparoscopic surgery].
abstract: BACKGROUND
  The factor Xa inhibitor, fondaparinux was used for prevention of venous thromboembolism in the clinical setting. We evaluated the antithrombotic effect, complications and economic aspects of this agent in the patients undergoing laparoscopic surgery.
  
  
  METHODS
  Forty one patients scheduled for laparoscopic abdominal surgery were divided into two groups. In group F (N = 33), patients received once-daily subcutaneous injection of fondaparinux (2.5 mg x day(-1)) for 4 postoperative days. In group E (N = 8), patients did not receive therapy. In group F, general anesthesia with transversus abdominis plane (TAP) block was administered during surgery, and general anesthesia with epidural anesthesia was performed in group E. We evaluated incidence of DVT (deep vein thrombosis), abnormal bleeding, other postoperative complications, and economic benefit to the hospital.
  
  
  RESULTS
  In both groups, no patient developed DVT Abnormal bleeding was observed in 7 patients of group E. Postoperative complications and pain were not different between the two groups. The revenue in group F was 34,434 yen/patient lower than that of group E due to Japanease insulance system.
  
  
  CONCLUSIONS
  No patients developed DVT and severe complications of fondaparinux after laparoscopic abdominal cancer surgery. However, revenue to the hospital decreased 34,434 yen/patient by use of analgestic method. We must consider cost-benefit in use of fondaparinux.
authors: Department of Anesthesiology, Osaka Police Hospital, Osaka 543-8502.
authors: Naoko
authors: N
authors: Fujita
authors: Tomoaki
authors: T
authors: Shimizu
authors: Takashi
authors: T
authors: Kita
authors: Shigeta
authors: S
authors: Sasaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D003110:Colonic Neoplasms / Q000601:surgery; D003362:Cost-Benefit Analysis; D004469:Economics, Hospital; D065427:Factor Xa Inhibitors; D005260:Female; D000077425:Fondaparinux; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D011183:Postoperative Complications / Q000517:prevention & control*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D011134:Polysaccharides; D000077425:Fondaparinux