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

The effect of continuous thoracic epidural analgesia (TEA) on the occurrence of postoperative deep vein thrombosis (DVT) was studied with the [125I]-fibrinogen uptake test in patients undergoing elective gallbladder surgery. The 98 patients were randomly allocated to three groups, viz. TEA for 24 hours, TEA plus general anesthesia with intermittent positive-pressure ventilation (IPPV) and general anaesthesia with IPPV but no TEA. The frequency of DVT was 13% in the group with general anaesthesia only and 7% in both of the other groups.
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PMID:Thoracic epidural analgesia and deep vein thrombosis in cholecystectomized patients. 675 56

One hundred and thirty-two elderly patients undergoing emergency hip surgery were randomly allocated to receive subarachnoid block (SAB) or general anaesthesia (GA). Using the 125.I fibrinogen uptake test, deep vein thrombosis was found to occur in 17 of 37 patients in the SAB group and 30 of 39 patients in the GA group (P 0.05). Blood loss was 513 ml (+/- SEM 44) in the SAB group and 714 ml (+/- SEM 67) in the GA group (P less than 0.01). Hypoxaemia was present preoperatively (mean PaO2 9.2 kPa). Immediately following general anaesthesia, the mean fall in PaO2 was 0.86 kPa compared with preoperative values but only 0.16 kPa following subarachnoid block (P less than 0.01). At 24 hours postoperatively the fall in PaO2 was similar in both groups and recovered only slowly during the first week. Twelve patients died, three in the SAB group and nine in the GA group. This difference in mortality was not statistically significant.
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PMID:Spinal anaesthesia or general anaesthesia for emergency hip surgery in elderly patients. 679 18

In an investigation of deep venous thrombosis and pulmonary embolism, where neither dextran nor other antithrombotic drug prophylaxis was employed, 30 patients subjected to total hip replacement under general anaesthesia were randomly allotted to one of two groups. One group (n=15) received tocainide, an oral analogue of lidocaine, as a means of preventing thromboembolism; the other group (n=15) served as a control. In patients given tocainide the frequency of deep venous thrombosis involving the femoral veins, as observed at phlebography, was 60% (9 of 15), and in the control group 73% (11 of 15). The frequency of pulmonary embolism, as determined by pulmonary perfusion lung scanning, was 20% (3 of 15) in the the tocainide group and 33% (5 of 15) in the control group. It was concluded that tocainide administration had no effect as an antithromboembolic agent. Phlebography revealed that the pattern of deep venous thrombosis after total hip replacement was characterized by a high frequency of isolated thigh vein thrombi in the operated leg, probably related to the surgical procedure. A finding of possible clinical significance was that patients given tocainide had a significantly lower intraoperative blood loss than control patients.
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PMID:Effects of tocainide, an oral analogue of lidocaine, on thromboembolism after total hip replacement. 679 34

The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacaine with epinephrine intraoperatively; for pain relief in the postoperative period (24 h), 0.25% bupivacaine with epinephrine was given every 3 h. General anesthesia (N = 30) consisted of controlled ventilation with N2O-O2 and intravenous fentanyl and pancuronium bromide; postoperatively, narcotic analgesics were given intramuscularly on demand for pain relief. Significantly lower frequencies were found following epidural anesthesia than after general anesthesia in deep venous thrombosis involving the popliteal and femoral veins (13% and 67%, respectively), deep venous thrombosis involving both calf and thigh veins (40% and 77%), and pulmonary embolism (10% and 33%). Possible explanations for these differences include increased circulation in the lower extremities, less tendency for intravascular clotting to occur, and more efficient fibrinolysis in association with continuous epidural anesthesia. The decrease in blood loss associated with epidural anesthesia with lower transfusion requirements also might play a role. Epidural analgesia prolonged into the postoperative period, in addition to other appropriate thromboprophylactic measures, should be of value in patients undergoing operations associated with a high risk of thromboembolic complications.
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PMID:Thromboembolism after total hip replacement: role of epidural and general anesthesia. 682 20

Coagulation studies and the J-125-fibrinogen-uptake-test for diagnosis of deep vein thrombosis were carried out in 244 and 288 patients resp. undergoing vaginal or abdominal hysterectomy. They were given a prophylaxis with 2 X 5000 IU calcium heparin (Calciparin) or 2 X 5000 IU sodium heparin with 0.5 mg dihydroergotamine (Heparin-Dihydergot). Control patients received acenocoumarol (Sintrom). The incidence of deep vein thrombosis was lowest in the heparin/dihydroergotamine group and was 5.9%. With calcium heparin prophylaxis it was 15.5%, and with acenocoumarol 12.2%. Plasma heparin levels and parameters of coagulation, fibrinolysis and platelet function showed that after 8 days of heparin prophylaxis with or without dihydroergotamine there is no change in hemostasis towards an increasing hypo- or hypercoagulability. Coagulation changes and the incidence of postoperative wound hematoma were identical using heparin alone or in combination with dihydroergotamine. Thus the improved effectiveness of heparin/dihydroergotamine in prevention of deep vein thrombosis which has been shown in the fibrinogen test cannot be explained by an effect onto the coagulation parameters studied. It is pointed out that a peridural anesthesia can be carried out in low-dose heparin and heparin/dihydroergotamine prophylaxis without the risk of bleeding and that the incidence of wound hematoma can be reduced by correct choice of the site of injection.
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PMID:[Postoperative changes in hemostasis by heparin/dihydroergotamine prevention]. 686 45

Electrical calf muscle stimulation during surgery has been used for the prevention of deep vein thrombosis (DVT) with varied results in several studies. This effect is mainly achieved by the reduction of venous stasis in the legs. Another possible beneficial effect might be an increased fibrinolytic activity of the blood secondary to the muscle contractions. Previously, single electrical impulses have been used for stimulation, giving rise to 'single twitches' in the muscles. In the present study the effect on calf volume of muscle stimulation with groups of impulses giving a short-lasting tetanus was investigated. Changes in calf volume were recorded by strain gauge plethysmography. Optimal values for duration, number and frequency of the impulses within the groups were determined. Stimulation with groups of impulses reduced calf venous volume approximately three times more efficiently than stimulation with single impulses. Calf muscle stimulation did not enhance the increase in fibrinolytic activity of venous blood observed after oesophago- or laryngoscopies under general anaesthesia.
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PMID:Electrically induced short-lasting tetanus of the calf muscles for prevention of deep vein thrombosis. 697 52

A prospective randomized trial is described in 119 patients undergoing major abdominal general surgical procedures. Half of the patients were treated prophylactically with intermittent pneumatic calf compression, begun after the induction of anesthesia and continued until the patient was walking; the other half acted as controls. Deep venous thrombosis was detected by iodine-125 fibrinogen scanning and confirmed by venography, and did not differ significantly in the control and treated groups. One fatal pulmonary embolism occurred in each group. The presence of malignancy of the gastrointestinal tract did not influence the results. The findings suggest that pneumatic compression delayed the development of deep venous thrombosis postoperatively and that perhaps it should be continued until discharge from hospital.
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PMID:Intermittent pneumatic calf compression for prevention of deep venous thrombosis in general abdominal surgery. 702 75

In an investigation on deep venous thrombosis and pulmonary embolism, where neither dextran nor antithrombotic drug prophylaxis were employed, 30 patients undergoing total hip replacement were randomly allotted to one of two groups receiving either epidural or general anaesthesia. The epidural group (n = 15) was given 0.5% bupivacaine with epinephrine (5 micrograms/ml) and this was prolonged into the postoperative period for pain relief. The general anaesthesia group (n = 15) was operated on under artificial ventilation with nitrous oxide/oxygen via an endotracheal tube and intravenously administered fentanyl and pancuronium bromide. In this group of patients narcotic analgesics (ketobemidone) were given intramuscularly on demand for pain relief postoperatively. The frequency of deep venous thrombosis involving the femoral veins, as observed at phlebography, was significantly lower in patients receiving continuous epidural block (3 of 15; 20%), than in those receiving general anaesthesia and parenteral analgesics postoperatively (11 of 15; 73%). Further, the frequency of pulmonary embolism, as determined by pulmonary perfusion lung scanning, was lower in patients receiving continuous epidural block (2 of 15) than in the general anaesthesia group (7 of 15). Possible explanations for these findings are discussed, including a hyperkinetic lower limb blood flow and lower fibrinolysis inhibition activity in patients given epidural block. Lower blood transfusion requirements in patients given epidural block might also play a role, as well as a "stabilizing" effect of local anaesthetics on platelets, leukocytes and endothelial cells.
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PMID:Comparative influences of epidural and general anaesthesia on deep venous thrombosis and pulmonary embolism after total hip replacement. 732 41

Numerous studies in recent years have documented the increased risk of perioperative complications in patients with pulmonary disease. In assessing lung function before anesthesia and surgery, history and physical examination may be helpful but spirometry and blood gas determination are more accurate indicators of significant pulmonary disease. Risk apparently can be minimized by intensive chest therapy before and after surgery. Low-dose heparin therapy, in particular, is rec-mmended to prevent deep venous thrombosis and pulmonary embolism.
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PMID:Preoperative evaluation and perioperative management of patients with pulmonary disease. 735 May 61

Subarachnoid block (SAB) or general anaesthesia (GA) was induced in 85 patients undergoing total hip replacement. The frequency of deep vein thrombosis (DVT), assessed by fibrinogen uptake studies and venography, was 29% in those patients receiving SAB and 54% in the GA group. Total blood loss (intra-operative and post-operative wound suction drainage) in SAB group was 66% and total transfusion volume 52% of that of GA group. No morbidity attributable to SAB or to the associated arterial hypotension was detected.
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PMID:Spinal and general anaesthesia in total hip replacement: frequency of deep vein thrombosis. 742 16


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