人工膝関節全置換術術後早期投与におけるフォンダパリヌクスとエノキサパリンの比較検討

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  • Comparison between Fondaparinux and Enoxaparin in Early Administration after Total Knee Arthroplasty

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Background: The validity of fondaparinux and enoxaparin has been reported in the prevention of deep vein thronbosis and pulmonary embolism (DVT/PE) after total knee arthroplasty (TKA). We compared the effectiveness of early administration of these two drugs after TKA.<br>Methods: We studied 32 patients who underwent TKA in the period between May 2009 and May 2010. The operations were performed under general anesthesia and femoral nerve block, using an air tourniquet, and using cements for implant fixation. The patients were divided in two groups, use of 2.5mg fondaparinux once daily (Fa group), and use of 2000IU of enoxaparin twice daily (Ex group). The initial dose was administered between 12 and 21 hours after surgery and continued for 14 days. We compared the incidence of DVT/PE, bleeding complications, D dimer level, and hemoglobin (Hb) loss.<br>Results: DVT/PE occurred in 6 patients (38%) in the Fa group, and 3 (19%) in the Ex group. Bleeding complications occurred in none of the Fa group and 4 (25%) in the Ex group. There were no significant differences in D dimer level and Hb loss.<br>Conclusion: Our results indicate that enoxaparin decreases the incidence of DVT/PE compared with fondaparinux, but increases the bleeding complications.

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