[Complications following preventive treatment of thromboembolism with Dihydergot-heparin]

The observation of two cases of ergotism after administration of dihydroergotamine (Dihydergot-heparin (DHEH], led to review of the literature concerning documentation of the use of this drug in postoperative thromboembolism prophylaxis and the incidence of complications to this treatment. DHE is supposed to exert a selective constrictive effect on veins. There are now, however, numerous reports of ergotism because of arterial spasm. Some authors find better thromboembolic prophylactic effect, when DHE is used in combination with low-dose heparin (LDH) while others cannot show any advantages of using this drug. Several trials show that the best method for thromboembolic prophylaxis consists of graduated supportive stockings (TED) combined with LDH. The use of DHE in postoperative thromboembolism prophylaxis cannot be recommended. TED combined with LDH should be preferred.