The Journal of Bone and Joint Surgery, Vol 70, Issue 1 2-10, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Dihydroergotamine/heparin in the prevention of deep-vein thrombosis after total hip replacement. A controlled, prospective, randomized multicenter trial
NE Beisaw, AJ Comerota, HE Groth, GJ Merli, HH Weitz, RC Zimmerman, FJ Diserio and AA Sasahara
St. Vincent's Hospital, Worcester, Massachusetts.
In a randomized, double-blind, placebo-controlled multicenter trial, the
efficacy and safety of dihydroergotamine mesylate/heparin sodium as a
prophylactic agent for deep-vein thrombosis were evaluated in 148 patients
who were forty years old or more and who underwent total hip replacement.
The incidence of venographically proved postoperative deep-vein thrombosis
was 52 per cent in the placebo group and 25 per cent in the
dihydroergotamine mesylate/heparin sodium group (p = 0.002). Proximal
thrombi developed in only 5 per cent and extensive thrombi, in only 10 per
cent of the patients who received dihydroergotamine mesylate/heparin
sodium. In contrast, proximal thrombi and extensive thrombi developed in 19
and 25 per cent, respectively, of the patients in the placebo group (p less
than 0.05). Adverse reactions in the two groups did not differ
significantly: in the treatment group they consisted primarily of hematoma
at the site of injection (9 per cent), hematoma at the wound (5 per cent),
and excessive postoperative bleeding, and in the placebo group there was
hematoma at the site of injection (3 per cent). It was concluded that the
combination agent dihydroergotamine mesylate/heparin sodium was effective
and safe prophylaxis against deep-vein thrombosis for the patients who
underwent total hip replacement in this study.
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