In a prospective and randomized double-blind study in 630 general surgery patients with different thromboembolism prophylaxis (130 patients with 5000 and 122 with 2500 I.U. of heparin, 128 with a fixed combination of 2500 I.U. of heparin and 0.5 mg dihydroergotamine ((2500-heparin-DHE)), 124 with 0.5 mg DHE and 126 with a placebo, 3 × daily) the influence of the medication on blood coagulation was examined by repeated pre-and post-operative determinations of blood-and coagulation parameters (activated partial thromboplastin time, heparin-plasma level, AT III, thromboplastin time, fibrinogen, thrombin time, thrombocyte aggregation test, β-thromboglobulin, Hb, erythrocytes, hematocrit, thrombocytes and differential blood picture). The frequency of postoperative thromboses and pulmonary embolisms was investigated by means of the radiofibrinogen test and lung scintigraphy. The results show that the lowest thromboembolism rate occurs in that patient collective in which there is in addition to the heparin application a simultaneous hemostatic effect of DHE. Side effects of the prophylaxis and influences on blood coagulation are dependent on the amount of heparin administered both in the single-drug low-dose treatment and in the combination therapy. The lowest rate of side effects was found in the group receiving 3×2500 I.U. of heparin and in the combination group 2500-heparin-DHE, but the combination treatment additionally affords the same thromboembolism protection as the routinely applied 3×5000 I.E. of low dose heparin.
The subjective effects of low-dose propofol A double-blind study to evaluate dimensions of sedation and consciousness with low-dose propofol
