Efficacy of enoxaparin as athromboprophylactic agent in major lower limb orthopaedic surgeries

Author(s): Dr. M Rohith Reddy, Dr. Shaik Mohasin Kamal, Dr. H Bala Krishna Gadigar, Dr. Prasad Soraganvi and Dr. RP Raghavendra Raju

Abstract: Venous Thromboembolism (VTE) which consists of Deep Vein Thrombosis (DVT) & Pulmonary Embolism (PE) is a potentially fatal & common complication following major lower limb orthopaedic surgeries like Hip, Knee Arthroplasty & Hip fracture surgeries which fall under highest risk category for VTE stratification. Analysis of selected Indian articles show that rates of DVT with prophylaxis is 8% and without prophylaxis 14%. Therefore VTE prophylaxis is essential to prevent the mortality and morbidity associated with it. Low Molecular weight heparins like Enoxaparin is one of the leading anticoagulants registered for use worldwide and has a long track record of over several years for safety and efficiency in orthopaedic surgeries. 180 patients undergoing Surgeries for fracture around Hip, Femur fracture surgery, patients undergoing Hip and Knee Arthroplasty were given prophylaxis for DVT in the form of Inj. Enoxaparin 40 Mg S/C once a day for 10 days starting 12 hours after epidural catheter removal. Three Bilateral lower limb venous Doppler scans were done in all the patients, one at the time of admission, one on eleventh post op day and another on thirtieth post-operative day to look for development or progression of deep vein thrombosis. Only One Patient (0.55%) showed ultrasonographic evidence of proximal asymptomatic Deep Vein Thrombosis on the eleventh post-operative day. Patient was treated for the same and the thrombus resolved while on treatment as shown by repeat Doppler scan done on twentieth day following detection. No cases of Fatal Pulmonary embolism or major complications were noted in the study. Enoxaparin is a safe and effective thromboprophylactic agent when used for the duration of 10 days post operatively in Major lower Limb orthopaedic Surgeries.

DOI: https://doi.org/10.22271/ortho.2019.v5.i3l.1607