A Comparison of General Anesthesia and Regional Anesthesia as a Risk Factor for Deep Vein Thrombosis Following Hip Surgery: A Critical Review

SummaryWe evaluated the evidence in support of the suggestion that the risk of deep vein thrombosis after hip surgery is lower with regional than with general anesthesia. A literature search was performed to retrieve all articles which reported on the incidence of postoperative thrombosis in both fractured and elective hip surgery. Articles were included if the method of anesthesia used was reported and if they used mandatory venography. Based upon the quality of study design the level of evidence provided by a study was graded.In patients who did not receive prophylaxis there were high level studies in elective and fractured hip surgery. All studies showed a statistically significantly lower incidence of postoperative deep vein thrombosis with regional anesthesia (relative risk reductions of 46-55%). There were no direct comparative studies in patients who received prophylaxis. However, between study comparisons did not show even a trend towards to lower incidence of postoperative thrombosis with regional anesthesia.

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The incidence of deep vein thrombosis in Hong Kong Chinese after hip surgery for fracture of the proximal femur

British Journal of Surgery ◽

10.1002/bjs.1800660914 ◽

1979 ◽

Vol 66 (9) ◽

pp. 640-642 ◽

Cited By ~ 29

Author(s):

C. K. Mok ◽

F. T. Hoaglund ◽

S. M. Rogoff ◽

S. P. Chow ◽

A. Ma ◽

...

Keyword(s):

Hong Kong ◽

Deep Vein Thrombosis ◽

Proximal Femur ◽

Hip Surgery ◽

Hong Kong Chinese ◽

Vein Thrombosis ◽

Deep Vein

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Effect of Nursing Care Standards for Preventing Deep Vein Thrombosis among Patients Undergoing Hip Surgery on Nurses' Performance and Patients' Outcome

IOSR Journal of Nursing and health Science ◽

10.9790/1959-0601025162 ◽

2017 ◽

Vol 6 (1) ◽

pp. 51-62

Author(s):

Doaa M. El-SayedEad ◽

KameliaF. Abd-Allah ◽

Mohamed O. Hegazi ◽

Sabah S. Mohammed

Keyword(s):

Deep Vein Thrombosis ◽

Nursing Care ◽

Hip Surgery ◽

Vein Thrombosis ◽

Deep Vein

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SP7.1.2 DVT and Abdominoplasty: A Holistic 8-point protocol-based approach to prevent DVT

British Journal of Surgery ◽

10.1093/bjs/znab361.139 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Reyan Saghir ◽

Noman Saghir ◽

Renee Okhiria ◽

Manu Sidhu ◽

Terrell Okhiria ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Incidence Rate ◽

Lower Incidence ◽

Holistic Approach ◽

Incidence Rates ◽

Thromboembolic Events ◽

Compression Stockings ◽

Specific Approach ◽

Vein Thrombosis ◽

Deep Vein

Abstract Aim Plastic surgery as a speciality is afflicted with one of the highest incidence rates of thromboembolic events, with abdominoplasty procedures known to assimilate the greatest rates of Deep Vein Thrombosis (DVT). Methods A total of 1078 abdominoplasty patients were enrolled onto an 8-point prophylaxis protocol with an inclusive holistic approach over a 7- year period. A 4-week smoking, HRT and COC cessation period was imposed on all patients and a maximum BMI score of 40 was required of all preoperative patients. Participants were administered with compression stockings, flowtrons and enoxaparin. Individuals with a DVT history were also required to be 1-year treatment free prior to surgery. Furthermore, the protocol necessitated post-operative deambulation of fit patients within 4 hours. Results Between 2008 and 2013, no incidence of DVT was recorded in all 1078 abdominoplasty surgery patients, indicating the potential for this protocol to lead to a significantly lower incidence than any previously published methodology. Due to the zero-incidence rate of DVT, different hypotheses of DVT proportions were tested to find out the rates that could be statistically consistent with our sample, thereby providing conservative incidence rate estimates. Conclusion This 8-point DVT prophylaxis protocol is the first non-criteria based inclusive protocol aimed at preventing abdominoplasty-associated DVT. As a result, not a single incident of DVT was recorded over the seven-year period of this study. We therefore believe that a holistic and procedure-specific approach to prophylaxis can drastically reduce the occurrence of DVT in abdominoplasty surgery.

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Impedance Plethysmography in the Diagnosis of Asymptomatic Deep Vein Thrombosis in Hip Surgery

Archives of Internal Medicine ◽

10.1001/archinte.1991.00400110031007 ◽

1991 ◽

Vol 151 (11) ◽

pp. 2167 ◽

Cited By ~ 25

Author(s):

Giancarlo Agnelli

Keyword(s):

Deep Vein Thrombosis ◽

Impedance Plethysmography ◽

Hip Surgery ◽

Vein Thrombosis ◽

Deep Vein

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Prophylaxis Against Postoperative Thromboembolic Complications. A Comparison Between Dextran 70, Dihydroergotamin Heparin and a Sulphated Polysaccarid

10.1055/s-0039-1684856 ◽

1979 ◽

Author(s):

D. Bergqvist ◽

T. Hallböök ◽

B. Lindblad

Keyword(s):

Elective Surgery ◽

Hip Surgery ◽

Perfusion Scintigraphy ◽

X Ray ◽

Vein Thrombosis ◽

Dextran 70 ◽

Postoperative Thrombosis ◽

Fibrinogen Test ◽

Deep Vein ◽

Low Dose Heparin

Dextran 70, a fixed combination of dihydroergotamine and low dose heparin (DHEH) and a sulphated polysaccarid (PZ68B) have been compared for prevention of postoperative thromboembolism. The trial has been prospective with separate randomization of patients undergoing elective general surgery, elective hip surgery and hip frecture surgery. Deep vein thrombosis has teen diagnosed with the 125 I-fibrinogen test. In patients undergoing elective hip surgery pulmonary x-ray and perfusion scintigraphy have been made preoperatively and on postoperative day 7, The patients have been followed for 30 days to detect late fatal pulmonary emboli. 253 patients have been studied -(34 exclusions), the main results being as follows:In conclusion there is a good and equal prophylactic effect against postoperative thrombosis of DHEH and PZ68E in elective surgery, and the two methods are as effective as dextran 70 in hip fracture patients.

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