This is a Randomized prospective study (Non-funded) to know the
efficacy of low molecular weight heparin versus oral anti – coagulant
in Indian population for prevention of deep vein thrombosis in total
knee replacement. Inclusion criteria were age greater than 18 years,
surgery under any anesthesia, patient undergoing TKR, Indian origin.
Exclusion criteria were head injury, abdominal injury, poly trauma,
history of deep vein thrombosis, indwelling epidural catheter.
Total number of patients included in the study was 100. 50
patients were started on enoxaparin and 50 patients were stared on
oral anti-coagulant (25 patients were given dabigatran etexalate and 25
patients were given apixaban). Enoxaparin was given 12 hours prior
to the surgery whereas oral anticoagulant was started post operatively.
Dabigatran etexalate was started 6-8 hours after surgery and apixaban
was started 12-24 hours after surgery. Enoxaparin was given at a dose
of 40mg subcutaneously once daily. Dabigatran etexalate 110 mg stat
is given as first dose 6-8 hours after surgery then 220mg orally once
daily. Apixaban was given at dose of 2.5mg orally twice daily. In our
study detailed history of all the patients was taken and all the patients
were evaluated clinically every day for deep vein thrombosis during
the stay in hospital.
