A. Zelikovski et al., VENO-PRESS - A NEW SEQUENTIAL INTERMITTENT PNEUMATIC DEVICE FOR THE PREVENTION OF PERIOPERATIVE DEEP-VEIN THROMBOSIS, Israel journal of medical sciences, 32(12), 1996, pp. 1335-1337
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.