VENO-PRESS - A NEW SEQUENTIAL INTERMITTENT PNEUMATIC DEVICE FOR THE PREVENTION OF PERIOPERATIVE DEEP-VEIN THROMBOSIS

The prevention of peri-operative deep vein thrombosis (DVT) and the po tentially hazardous pulmonary embolism that may follow is still a majo r medical issue. Intermittent pneumatic compression is one of the many methods currently in use for this purpose. No information is availabl e, however, regarding the venous flow alterations that occur during em ployment of a pneumatic compression device under general anesthesia Th e aim bf this study is to delineate these venous flow variations and t o determine the optimal pump setting for the prevention of operative v enous stasis and its sequelae, postoperative DVT. A new sequential int ermittent pneumatic device, the ''Veno-Press'', was applied on 20 volu nteers of whom 10 were undergoing surgery unrelated to the lower limbs , during the pre-anesthesia and during general anesthesia The venous v elocity patterns over the femoral vein were depicted via duplex scanni ng under different pressure and rhythm settings of the device. The ''V eno-Press'' induced a marked augmentation in venous blood velocity flo w. A further 10-30% augmentation was noted when the patients were unde r general anesthesia, as well as a 10-30% increase in the femoral vein diameter. None of the patients developed postoperative DVT. This devi ce is a very efficient tool for augmentation of venous blood velocity, especially during general anesthesia. Its effectiveness is most proba bly the result of the compressive action over the relaxed - and hence enlarged - capacitant veins of the anesthetized patient. We suggest th at the ''Veno-Press'', if properly timed, is very efficient in venosta sis prevention, leading presumably to a decline in the occurrence of D VT and pulmonary embolisms in the surgical patient.