Is Blood loss reduced by delaying the first administration of a Direct Thrombin Inhibitor for Thromboprophylaxis in elective total knee replacement? – Original Study.
Journal Title: Advance Research Journal of Multidisciplinary Discoveries - Year 2018, Vol 30, Issue 30
Abstract
The primary aim of this study was to examine the correlation between the dabigatran administration initiation time (0-4 h vs. > 4 h post-surgery) and the respective blood loss in patients undergoing elective total knee replacement.Patients facing major orthopaedic operations, including total knee and total hip replacement, are at risk of venous thromboembolism. Dabigatranetexilate is a new oral, direct thrombin inhibitor, clinically approved for prophylaxis of thromboembolism in patients undergoing elective orthopaedic joint replacements.Patients selected for the study were split into two groups differing in the time of DE administration initiation (0-4 h vs. > 4post-surgery). The formula of Nadler was used for the quantitative determination of the peri-operative blood loss in these patients. There was no significant difference in the calculated mean blood loss between the two groups. The calculated mean blood loss for the 1-4 h group was 331ml, compared with 331 ml in the > 4 h group (p > 0.05). This showed no reduction in bleeding even with a delayed DE administration. Investigation of the delayed initiation ofdabigatran administration suggested that the late dabigatran administration have been due surgeon’s decision based on increased risk of bleeding. The efficacy and safety of DE administration was comparable at both times (0-4 h vs. > 4post-surgery) and no clinically significant disadvantage concerningperi-operative blood loss could be observed when performing an early administration initiation of DE.
Authors and Affiliations
Monika Rezacova, Vineet Batta, Yegappan Kalairajah
Keywords
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