Intravenous lignocaine in prevention of deep venous thrombosis after elective hip surgery

Intravenous lignocaine is a possible means of preventing deep venous thrombosis (D.V.T.) after elective hip surgery. In 14 control patients the total incidence of D.V.T. was 78%, with a 57% incidence of thigh-vein thrombosis. In 14 patients treated at random with intravenous lignocaine during the first 6 postoperative days, there were only 2 calf-vein thrombi (14%; P less than 0-005). In a further 14 cases treated consecutively there were 4 unilateral calf-vein thrombi. No thrombi originated in the thigh veins (P less than 0-001). After intravenous lignocaine was stopped the total incidence of D.V.T. in the 28 patients rose to 53% with a 21% incidence of thigh-vein thrombi between the 7th and 14th postoperative days. There was no significant difference in postoperative coagulation and fibrinolytic activity between control and treated patients, and blood loss and transfusion requirements were similar. Immediate or delayed hypersensitivity reactions to lignocaine were not observed. The results support the view that damage to the vessel wall may be the initial event in the formation of a venous thrombus.