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British Journal of Anaesthesia, Vol 78, Issue 6 660-665, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Low molecular weight heparin associated with spinal anaesthesia and gradual compression stockings in total hip replacement surgery

C. M. Samama, F. Clergue, J. Barre, A. Montefiore, P. Ill, K. Samii and Group. The Arar Study
Department of Anaesthesiology and Critical Care, La Pitie Salpetriere, Paris, France; Department of Anaesthesiology and Critical Care, Tenon Hospital, Paris, France; Department of Anaesthesiology and Critical Care, Robert Debre Hospital, Reims, France; Cardiovascular Department, Bellon-Rhone-Poulenc Rorer, Neuilly-sur-Seine, France; Department of Anaesthesiology and Critical Care, Le Kremlin Bicetre Hospital, Le Kremlin Bicetre, France; ARAR (Association pour la Recherche en Anesthesie Reanimation) STUDY GROUP

The benefit/risk ratio of administering heparin during spinal anaesthesia in patients undergoing total hip replacement (THR) has not been studied widely. We conducted a prospective, randomized, double- blind study to compare low molecular weight heparin (LMWH) for 10 days and placebo in patients undergoing THR performed under spinal anaesthesia associated with gradual compression stockings. Efficacy was assessed by systematic bilateral ascending venography on day 10 +/- 2 in a sequential analysis. Among the 170 patients enrolled, data were available in 153 patients. In the LMWH group (n = 78) the total incidence of deep vein thrombosis (DVT) was 14.1% compared with 37.3% in the placebo group (n = 75) (P = 0.0016). No gross neurological sequelae were observed during the study. This study showed that the addition of LMWH in patients undergoing THR under spinal anaesthesia and wearing gradual compression stockings significantly decreased the incidence of venogram-proved DVT.
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