[Prophylactic antithrombotic therapy after orthopedic surgery with bemiparin, a second-generation low molecular weight heparin]

Abstract

Objective: Bemiparin is a new second generation low molecular weight heparin with a molecular weight of 3,600 daltons and an anti-Xa/anti-IIa ratio greater than 8. The aim of this study was to evaluate the efficacy and safety of bemiparin administered at a daily dose of 3,500 IU anti-Xa (40 mg), with prophylaxis beginning 6 hours after total hip replacement surgery.

Patients and methods: Fifty-seven consecutive patients were evaluated by bilateral phlebography of the lower limbs 10 days after surgery. The patients were recruited at two centers specializing in orthopedic surgery.

Results: The incidence of deep venous thrombosis (DVT) in the series was 7% (95% CI: 0.4-13.7). In three patients (5%) DVT was proximal (95% CI 0-11.1). These results are consistent with those reported by Kakkar for bemiparin at the same dose begun two hours before surgery (incidence of DVT: 7.2%). No episodes of major bleeding were observed with this new protocol for postoperative administration. The incidence of wound hematoma was low and no patient required further surgery. The rate of post-operative bleeding was similar to that usually reported when low molecular weight heparin is used in hip surgery.

Conclusions: Thromboprophylaxis in orthopaedic surgery with bemiparin beginning 6 hours after surgery appears to be safe and effective.