Article

Detection and Prevention of Post-Operative Deep Vein Thrombosis [DVT] Using Nadroparin Among Patients Undergoing Major Abdominal Operations in India; a Randomised Controlled Trial.

Indian Journal of Surgery (impact factor: 0.08). 08/2010; 72(4):312-7. DOI:10.1007/s12262-010-0067-7 pp.312-7
Source: PubMed

ABSTRACT Deep vein thrombosis [DVT] is one of the most dreaded complications in post-operative patients as it is associated with considerable morbidity and mortality. Majority of patients with postoperative DVT are asymptomatic. The pulmonary embolism, which is seen in 10% of the cases with proximal DVT, may be fatal. Therefore it becomes imperative to prevent DVT rather than to diagnose and treat. Only one randomized trial has been reported from India to assess the effectiveness of low molecular weight heparin in preventing post-operative DVT. To assess the risk of DVT in North Indian patients following major abdominal operations and to evaluate the effectiveness of Nadroparin, A Low Molecular Weight Heparin (LMWH) therapy in preventing post-operative DVT. Sixty five patients were randomised preoperatively into Group-I; Nadroparin prophylaxis and Group-II: No prophylaxis. The primary outcome was the occurrence of DVT, diagnosed by bilateral lower limb venogram performed, seven to ten days after operation. Secondary outcome measures included adverse effects of radio-opaque dye, intra-operative blood loss, operating time, postoperative platelet count, intraoperative blood transfusion requirements and the total duration of postoperative bed rest. No case of DVT occurred in either group. There was no statistical difference in the risk of secondary outcome measures in the two groups. DVT was not observed in any of the patients, even with several high risk factors indicating a possible protective mechanism in the North Indian population.

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Keywords

bilateral lower limb venogram
 
dreaded complications
 
intra-operative blood loss
 
intraoperative blood transfusion requirements
 
low molecular weight heparin
 
major abdominal operations
 
North Indian patients
 
North Indian population
 
post-operative DVT
 
post-operative patients
 
postoperative bed rest
 
postoperative DVT
 
postoperative platelet count
 
proximal DVT
 
randomized trial
 
risk factors
 
Secondary outcome measures
 
total duration
 
two groups
 
vein thrombosis [DVT]