[Prevention of postoperative thrombotic complications with heparin and dihydroergotamine. A randomized double-blind study]

Abstract

In a randomized double-blind study of 660 patients with predominantly abdominal-surgical procedures the thrombosis-preventing effect of the following was compared: heparin 5000 (low-dose heparin), heparin 2500, a combination of heparin 2500 and 0.5 mg dihydroergotamine (HDHE 2500), 0.5 mg dihydroergotamine (DHE), and placebo. All preparations were administered three times daily. Radiofibrinogen test gave the following thrombosis incidence: heparin 5000-15.4%; heparin 2500-24%; HDHE 2500-13.2%; DHE-24.6%; placebo-28.9%. Bleeding complications, included postoperative blood loss (more than 500 ml), unusually marked bleeding from drains, seroma, wound haematoma, and re-operation. The rate of these complications was 18.5% with heparin 5000, 7.8% with placebo, 5.6% with DHE, 4% with heparin 2500 and 3.1% with HDHE 2500. The non-specific tolerance to the various preparations was good, especially in that there was no increased risk of coronary complications with HDHE or DHE, and there was no pointer to peripheral vasospasms. This study confirms the synergistic thrombosis-preventing effect of combined heparin-dihydroergotamine.