The Journal of Bone and Joint Surgery, Vol 72, Issue 10 1456-1461, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
The effect of intravenous fixed-dose heparin during total hip arthroplasty on the incidence of deep-vein thrombosis. A randomized, double-blind trial in patients operated on with epidural anesthesia and controlled hypotension
NE Sharrock, WW Brien, EA Salvati, R Mineo, K Garvin and TP Sculco
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, N.Y. 10021.
Heparin was given in fixed doses intravenously during unilateral primary
total hip-replacement operations in a prospective, double-blind trial to
assess the effect on the incidence of deep-vein thrombosis. One hundred and
fifty patients were randomly assigned to one of two groups before the
operation. Twenty-four patients were excluded from the study, leaving 126
patients. Group I consisted of sixty-six patients who received saline
solution intravenously, and Group II comprised sixty patients who received
heparin. All patients had epidural anesthesia with controlled hypotension.
Fixed doses of heparin were administered five minutes before the operative
incision was made and every thirty minutes throughout the operation. Mean
arterial pressures were maintained at between fifty and sixty millimeters
of mercury in all patients. Ascending venography was done on the seventh
day after the operation. The incidence of deep-vein thrombosis was 24 per
cent (sixteen of sixty-six patients) in Group I and 8 per cent (five of
sixty patients) in Group II; the difference is significant (p = 0.03). The
intraoperative loss of blood averaged 220 +/- 79 milliliters in Group I
compared with 269 +/- 109 milliliters in Group II. An average of less than
one unit of blood was transfused for each patient in each group.
Postoperatively, there was no difference between the groups with regard to
the amount of drainage that was collected in a Hemovac device or the values
for hematocrit.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
