[Postoperative changes in hemostasis by heparin/dihydroergotamine prevention]

Area of Science:

• Thrombosis and Hemostasis
• Surgical Prophylaxis

Background:

• Deep vein thrombosis (DVT) is a significant risk following hysterectomy.
• Effective prophylaxis is crucial to reduce postoperative complications.

Purpose of the Study:

• To compare the efficacy of different prophylactic regimens for deep vein thrombosis (DVT) in patients undergoing hysterectomy.
• To investigate the impact of these regimens on coagulation parameters and wound hematoma formation.

Main Methods:

• Coagulation studies and iodine-125-fibrinogen uptake tests were performed in patients undergoing vaginal or abdominal hysterectomy.
• Prophylaxis groups received calcium heparin, sodium heparin with dihydroergotamine, or acenocoumarol.
• Incidence of DVT, plasma heparin levels, and coagulation/fibrinolysis/platelet function were assessed.

Main Results:

• The heparin/dihydroergotamine group showed the lowest DVT incidence (5.9%), compared to calcium heparin (15.5%) and acenocoumarol (12.2%).
• No significant changes in hemostasis (hypo- or hypercoagulability) were observed after 8 days of heparin prophylaxis.
• Postoperative wound hematoma incidence and coagulation changes were similar between heparin alone and heparin/dihydroergotamine groups.

Conclusions:

• Heparin combined with dihydroergotamine offers superior prophylaxis against deep vein thrombosis after hysterectomy.
• The enhanced efficacy of heparin/dihydroergotamine is not attributable to alterations in studied coagulation parameters.
• Low-dose heparin and heparin/dihydroergotamine are safe for use with peridural anesthesia, and careful injection site selection can minimize wound hematoma.