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Clin Appl Thromb Hemost. 2007 Jul;13(3):249-58.

Prophylaxis of venous thromboembolism in minor orthopedic surgery with parnaparin.

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Servizio di Anestesia e Rianimazione-IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.


This study analyzed the efficacy of venous thromboembolism prophylaxis in knee arthroscopy in 509 patients who received Parnaparin (Alfa Wassermann, Bologna, Italy), 3200 IU to 4250 IU daily, after minor arthroscopic knee surgery. No proximal deep venous thrombosis or other thromboembolic events occurred. Adverse events related to the treatment with Parnaparin were observed in 2 of 172 patients treated with 3200 IU/d and in 6 of 337 patients treated with 4250 IU/d, without any evidence of dose-proportionality in the incidence. Prophylaxis with a low-molecular-weight heparin such as Parnaparin should be considered in all patients who will be undergoing a procedure in which a tourniquet is used. If Parnaparin is used, it should be started immediately after knee arthroscopy at doses of 3200 to 4250 IU/d, according to the characteristics of the patients. Depending on the patient's risk factors, postoperative prophylaxis for 10 days may be appropriate.

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