THROMBOSIS PROPHYLAXIS WITH LOW MOLECULAR WEIGHT HEPARIN (KABI 2165) AND CALCIUM HEPARIN IN PATIENTS WITH TOTAL HIP REPLACEMENT

Abstract

In a prospective controlled randomized trial efficacy and safety of a low molecular weight heparin (Kabi 2165) and calcium heparin were compared in 80 patients with total hip replacement. 40 patients were given Kabi 2165 : 2,500 anti-Xa Units S.C. 2 hours before operation and then every 12 hours for 10 days. 40 patients received calcium heparin : 5,000 iu S.C. 2 hours before operation, then every 8 hours during the first post operative day and then heparin doses were adjusted according to the activated partial thromboplastin time and the thrombin time for 10 days. Bilateral venography was performed routinely on all patients between the ninth and tenth post operative day. The two groups were well matched for risk factors which could predispose to risk of developing venous thrombosis. 7 patients in Kabi 2165 group (17,5 96) and 4 patients in calcium heparin group (10 %) developed D.V.T. (p = 0.33). In 3 patients (7,5 96) of Kabi 2165 group and in 2 patients (5 96) of calcium heparin group, the thrombi extented to the popliteal-femoral vein. The incidence is not significantly different (p = 0,50). There were no significant differences in postoperative mean estimated blood losses, and mean blood units transfused. Mean hemoglobin levels and mean hematocrit values at the day before operation, the 1st, 5th, and 10th day after operation were :These differences were not statistically significant. Incidence of wound hematomas was similar in both groups No thrombocytopenia was reported in this study. In conclusion, Kabi 2165 2,500 anti Xa Units twice daily seems as efficient as adjusted-dose of calcium heparin thrice daily.