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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two hundred and seventy-six women over 50 years of age who had gynecologic surgery were followed postoperatively with the 125I-fibrinogen uptake test (125I-FUT) to detect deep venous thrombosis (DVT). By using a newly devised technique based on conventional 125I-FUT, the exact depth of thrombi could be determined. The correlation between the results with our new technique and those from phlebography was almost 100%. Forty-seven (17%) of the women developed DVT postoperatively, 60% of them occurring in the calf muscle veins. Patients subjected to abdominal hysterectomies for malignant diseases had the highest incidence of DVT (36%), whereas those operated on for benign diseases with the same technique had the lowest (11%). Patients operated on for uterine prolapse had an intermediate DVT frequency of 15% but advanced age and estrogens given preoperatively increased the frequency. Neither the type of anesthesia (epidural or general), nor the duration of the operation, significantly influence the incidence of DVT in this study.
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PMID:Incidence of thrombosis after gynecologic surgery evaluated by an improved 125I-fibrinogen uptake test. 616 78

The occurrence of deep vein thrombosis (DVT) was studied by the 125-I-fibrinogen uptake test in 38 patients subjected to retropubic prostatectomy. The patients were randomly allocated to two groups: continuous lumbar epidural analgesia for up to 24 hours and general anaesthesia with intermittent positive pressure ventilation. Two of the 17 patients in the epidural group (12%) developed DVT in contrast 11 of the 21 patients in the general anaesthetic group (51%). The difference between the groups was significant. It is concluded that epidural analgesia offers a protection against postoperative DVT and is worth further investigation.
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PMID:The effect of lumbar epidural analgesia on the development of deep vein thrombosis of the legs after open prostatectomy. 617 22

In 38 patients subjected to retropubic prostatectomy the effects of continuous lumbar epidural analgesia for 24 hours and the thiopentone- oxygen-nitrous oxide- alcuronium-pethidine sequence with artificial ventilation on the serum activities of aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), alpha-hydroxybutyrate dehydrogenase (HBD), and alkaline phosphatase (AP) have been studied. Per- and postoperative complications were recorded according to a prearranged plan designed to quantify the peroperative haemorrhage, postoperative deep vein thrombosis, pulmonary, circulatory and infectious complications. ASAT, ALAT and AP in the general group and ALAT in the epidural group showed significant increases on the 5th and 7th postoperative days. There existed no statistically significant difference between the groups. 82% of the patients with documented postoperative complications combined with hypoxaemia showed a pathologic liver enzyme pattern in contrast to 9% of the patients with uneventful postoperative course. It is concluded that the method of anaesthesia did not have an effect on the liver enzymes. Complications combined with postoperative hypoxaemia seemed to be the factors responsible for the increases of liver enzymes.
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PMID:Liver enzymes after retropubic prostatectomy in patients receiving continuous lumbar epidural analgesia or general anaesthesia. 618 33

A prospective study was performed in 120 patients undergoing total hip arthroplasty. The patients were randomly allocated to four groups. The first two groups had nitroprusside-induced hypotensive anesthesia with either a fixed combination of sodium heparin and dihydroergotamine mesylate (HDHE) or dextran 70. The other two groups had normotensive halothane anesthesia with either HDHE or preoperative hemodilution with dextran 70. Hypotensive anesthesia reduced surgical bleeding. Blood loss was increased in patients undergoing preoperative hemodilution as compared to thromboprophylaxis with HDHE, whereas no difference was found between conventional administration of dextran and HDHE. Deep vein thrombosis, diagnosed with ascending phlebography of the operated leg, was registered in 48% of the patients. There was no difference between the techniques of anesthesia and thromboprophylaxis. Pulmonary embolism, studied with perfusion-ventilation scintigraphy, was diagnosed in 19% of the patients. No significant difference was found between hypotensive and normotensive anesthesia, or between thromboprophylaxis with conventional dextran and HDHE. There was a lower incidence of pulmonary embolism in patients with HDHE and normotensive anesthesia. Major wound hematomas were noted postoperatively in 12% of the patients receiving HDHE, whereas no major hematomas developed following dextran prophylaxis. No anaphylactic reaction was noted from dextran 70, using hapten-dextran prophylaxis.
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PMID:Hypotensive anesthesia, thromboprophylaxis and postoperative thromboembolism in total hip arthroplasty. 620 42

In a randomized double-blind study of thirty grossly obese patients undergoing gastroplasty for weight reduction, the effects of intramuscular and epidural morphine were compared as regards analgesia, ambulation, gastrointestinal motility, early and late pulmonary function, duration of hospitalization, and occurrence of deep vein thrombosis in the postoperative period. The patients were operated on under thoracic epidural block combined with light endotracheal anesthesia. A six-grade scale was devised to quantify postoperative mobilization. A radioactive isotope method using 99mTc -plasmin was employed to detect postoperative deep vein thrombosis. For 14 hr after the first analgesic injection, respiratory frequency was noted every 15 min and arterial blood gases were measured hourly. Peak expiratory flow was recorded daily until the patient was discharged from hospital. Spirometry was performed the day before and the day after surgery. Plasma concentrations of morphine were measured after both intramuscular and epidural administration. Both intramuscular and epidural morphine gave effective analgesia, but the average dose of intramuscular morphine was up to seven times greater than that required by the epidural route. A larger number of patients receiving epidural morphine postoperatively were able to sit, stand, or walk unassisted within 6, 12, and 24 hr, respectively. Being alert and more mobile as a result of superior postoperative analgesia from epidural morphine, patients in this group benefited more from vigorous physiotherapy routine, which resulted in fewer pulmonary complications. Furthermore, earlier postoperative recovery of peak expiratory flow and bowel function presumably contributed to a significantly shorter hospitalization in patients receiving epidural morphine. There was no evidence of prolonged respiratory depression in this high-risk category of patients. The 99mTc -plasmin tests revealed no significant difference between the two groups.
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PMID:Comparison of intramuscular and epidural morphine for postoperative analgesia in the grossly obese: influence on postoperative ambulation and pulmonary function. 623 17

Postoperative pulmonary embolism continues to be a problem in patient care, especially in high-risk patients. This study was designed to evaluate a combined pharmacologic approach to the prophylaxis of postoperative deep venous thrombosis (DVT) by mediating at least two and probably three of Virchow's predisposing factors. Patients 40 years of age and older undergoing operations greater than 45 minutes under general anesthesia were placed in one of five treatment groups and studied by a prospective randomized, double-blind protocol. Study drugs were the following: (1) 0.5 mg of dihydroergotamine plus 5000 IU of sodium heparin (DHE 5000), (2) 0.5 mg DHE plus 2500 IU heparin (DHE 2500), (3) 5000 IU of HEP (HEP 5000), (4) 0.5 mg of DHE (DHE 0.5), and (5) a placebo. Study medications were administered 2 hours preoperatively and continuously thereafter every 12 hours postoperatively subcutaneously in the anterior abdominal wall for 5 to 7 days or until a positive radiofibrinogen uptake test (RFUT). The RFUT was performed according to standardized technique and was used to establish the presence or absence of DVT. This report is an analysis of the major subgroup of patients undergoing intra-abdominal operations. Results showed a highly statistically significant prophylactic benefit from DHE 5000 compared with the placebo (p less than 0.003) and all other treatment groups (p less than 0.05). There was no significant benefit from DHE 2500, HEP 5000 (p greater than 0.13), and DHE 0.5 (p greater than 0.3). All patients who entered the study had two or more risk factors for postoperative DVT, and high-risk patients were distributed equally throughout all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prophylactic efficacy of low-dose dihydroergotamine and heparin in postoperative deep venous thrombosis following intra-abdominal operations. 638 9

The incidence of postoperative deep vein thrombosis in 120 patients undergoing elective total hip replacement was determined venographically. Significantly more blood was administered to those developing thrombosis, particularly in the subgroups given general anaesthesia (P less than 0.05). There were no differences in the postoperative haemoglobin values in any of these groups. The distribution of other risk factors identified, namely previous thrombo-embolism, malignancy and previous vein surgery or injections did not influence this finding. The use of TED stockings (Kendall) was effective. It is suggested that greater emphasis should be placed on techniques that reduce blood loss such as regional anaesthesia and the posterior approach to the hip. Further research into the fluids used for blood volume maintenance will be beneficial.
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PMID:The effect of blood transfusion on the incidence of deep vein thrombosis. 657 54

The records and radiographs of 162 patients with 224 total knee replacements were reviewed for evidence of complications. Early complications included cardiovascular abnormalities, in particular deep vein thrombosis (3%), and limitation of motion requiring manipulation under anesthesia (7%). Late problems included patellofemoral arthritis (11%), heterotopic bone formation (10%), loosening (7%), deformity (4%), fracture (3%), and infection (2%). Patellofemoral pain and arthritis is the most common and often the most disabling complication.
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PMID:Complications of total knee replacement. 660 86

In a prospective study of 50 patients subjected to major abdominal surgery, the frequencies of postoperative deep vein thrombosis and pulmonary embolism were analysed. The patients were randomized to one of two groups receiving either neurolept anaesthesia or neurolept anaesthesia combined with thoracic epidural analgesia. Five patients were excluded. No special anti-thrombotic prophylaxis was administered. Deep vein thrombosis was diagnosed with the 125I-fibrinogen test and pulmonary embolism with pre- and postoperative lung perfusion scintigraphy combined with lung X-ray. Patients with positive scintigraphy were subjected to pulmonary angiography for verification of the diagnosis. Deep vein thrombosis was treated when diagnosed. The frequency of deep vein thrombosis was equal in both groups (38%). No patient with pulmonary embolism was recorded during the first seven days after operation. It is concluded that the addition of thoracic epidural analgesia to neurolept anaesthesia does not alter the postoperative frequency of deep vein thrombosis in patients subjected to major abdominal surgery. Early diagnosis and treatment of postoperative deep vein thrombosis might prevent pulmonary embolism. Problems encountered in the diagnosis of postoperative pulmonary embolism are discussed.
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PMID:Thromboembolic complications after major abdominal surgery: effect of thoracic epidural analgesia. 661 61

The effect of lumbar epidural analgesia and of general anaesthesia on the peroperative velocity of flow in the femoral vein was measured with Doppler ultrasound technique in 38 patients undergoing retropubic prostatectomy. The patients were randomly allocated to the epidural or the general procedure. The 125I-fibrinogen test was used to detect deep vein thrombosis (DVT). Epidural analgesia was associated with a significant (ca. 120%) increase in the femoral venous flow velocity. The peak flow showed a moderate (47%) increase, whereas the minimum flow was greatly increased (188%). The increase was significant already 2 min after induction of the analgesia and the rate continued to rise for about 11 min. General anaesthesia significantly reduced the flow velocity in the femoral vein. Immediately after induction of the anaesthesia the velocity approached zero, but gradually rose, and after about 8 min was stabilized at level 40% below the preoperative velocity. The peak flow velocity in all patients of this group fell by 24 to 40%. Only 2 of 17 patients with epidural analgesia, but 11 of 21 with general anaesthesia had postoperative DVT. In the 11 patients with DVT the mean minimum velocity of flow was decreased (by 85%), but in the 10 without DVT it was increased (by 175%). The difference was not statistically significant. Increased velocity of flow in the femoral vein, especially of minimum flow, seems to counteract development of DVT.
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PMID:Effects of lumbar epidural analgesia and general anaesthesia on flow velocity in the femoral vein and postoperative deep vein thrombosis. 661 74


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