Enoxaparin versus heparin for the prophylaxis of post-operative deep vein thrombosis in general surgery

Abstract EN

Background: Patients undergoing surgery with a prolonged general anesthesia or a period of a limited postoperative mobility, or both, face a high risk of thromboembolism.

Surgical procedure is considered as the third most common risk factor for thromboembolism after old age and obesity.

Purpose: To asses the value of enoxaparin in the prophylaxis of venous thromboembolism and the possible complications in comparison to heparin in high risk patients undergoing general surgery.

Patient and Methods: In the period between March 2003 and May 2005, 200 patients admitted for different surgical procedures were randomized into 2 equal groups: (1) Group A where unfractionated heparin was used as a prophylactic anticoagulant drug, and (2) Group B where enoxaparin was utilized.

Patients were obese with one or more risk factors for deep vein thrombosis.

Clinical and laboratory assessment in addition to venous duplex scanning of the lower limbs were performed.

Results: The ages of the patients ranged from 40 to 82 years with a mean of 61 years.

A mean preoperative hospitalization period of 6.1 days and a mean operative duration of 95 minutes was recorded.

Postoperative deep venous thrombosis (DVT) occurred in 10 (5%) patients, 8 of them were asymptomatic (4 in each group) and diagnosed by duplex ultrasound.

The 2 remaining patients had symptomatic DVT, both were in group A.

Bleeding complications occurred in 30% and 16% patients of group A and group B, respectively.

Conclusions: Low molecular weight heparin (enoxaparin) is more effective and safer than unfractionated heparin, but with higher costs in the prophylaxis of postoperative deep venous thrombosis.