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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 2  |  Page : 437-441

A comparative study between fondaparinux, a low-molecular-weight heparin, and recombinant hirudin in thromboembolic prophylaxis after major abdominal surgery in the surgical intensive care unit


Department of Anaesthesia and Critical care, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt

Correspondence Address:
Hager H Mohammady
Department of Anaesthesia and Critical Care, Faculty of Medicine, Menoufia University, Shebin El-kom, Menoufia Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.163898

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Objective Evaluation of the safety and the efficacy of different anticoagulants in thromboembolic prophylaxis after major abdominal surgeries. Background Thromboembolic events are serious complications after major abdominal surgeries, and there are different modalities to prevent them. Materials and methods Sixty patients who underwent major abdominal surgery were assigned in a randomized, double-blinded manner and classified into three groups: group A (n = 20) was started on enoxaparin at a daily dose of 40 mg. Group B (n = 20) was given recombinant hirudin 15 mg twice daily. Group C (n = 20) was given fondaparinux 2.5 mg subcutaneously daily. The duration of treatment was 5-12 days. The efficacy of the three drugs was compared by the occurrence of DVT (assessed by Doppler ultrasound) or fatal and nonfatal pulmonary embolism (by computed tomography). The safety was assessed by postoperative bleeding in terms of the number of transfused whole blood units, plasma expanders, or packed red blood cells and fatal bleeding. Results Results showed that enoxparin, fondaparinux, and recombinant hirudin were equally effective in the prevention of thromboembolism. The least risk of postoperative bleeding was noticed in patients receiving enoxparin in comparison with patients receiving fondaparinux or recombinant hirudin. Conclusion Enoxaparin, hirudin, and fondaparinux are equally effective in protection against thromboembolic events in patients undergoing major abdominal surgeries; however, enoxaparin is superior to the others regarding safety.


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