The safety and efficacy of intraoperative heparin in total hip arthroplasty

A single dose of unfractionated heparin (15 U/kg), administered intravenous ly before surgery on the femur suppresses thrombogenesis during total hip r eplacement, Nine hundred eighty-nine patients (1021 hips) who received one dose of intraoperative heparin,vith hypotensive epidural anesthesia were fo llowed up prospectively for 3 months, Asymptomatic deep vein thrombosis ass essed by ultrasound in the first 198 consecutive patients showed an inciden ce of 7.1% (14 of 198), The incidence of clinical deep vein thrombosis in t he subsequent 791 patients was 0.88% (seven of 791), Symptomatic pulmonary embolism occurred in 0.5% (five of 989), No patients died and there was one major bleeding episode. Based on this favorable experience, intraoperative heparin appears safe and efficacious as thromboembolic prophylaxis.