Noncompliance in the inpatient administration of enoxaparin in conjunctionwith epidural or spinal anesthesia

Deep venous thrombosis is 1 of the most common postoperative complications resulting in significant mortality and morbidity in patients undergoing tot al hip and total knee arthroplasty. Research has shown that the effectivene ss and safety of low-molecular-weight heparins depend on the timeliness of their administration, particularly when used in conjunction with spinal or epidural anesthesia, bath of which are effective and safe treatment modalit ies for knee and hip arthroplasty. The focus of this study was to examine t he compliance with current protocols in the administration of enoxaparin (L ovenox) to patients who had undergone total joint arthroplasty. We reviewed the perioperative management of patients who had a total hip or total knee arthroplasty in which there was the combined use of epidural or spinal ane sthesia and enoxaparin. Our results show a 52% (26 of 50) noncompliance rat e in the administration of enoxaparin as compared with the published protoc ol for using this treatment modality safely and effectively.