Analgesia Problems in Trauma and Orthopedic Patients in the Postoperative Period Who Undergo Thromboprophylaxis: Safety of Co-administration of Non-steroidal Anti-Inflammatory Drugs and Low Molecular Weight Heparins

Yu.L. Kuchyn

Abstract


The objective of the study was to evaluate the safety of co-administration of non-steroidal anti-inflammatory drug (NSAID) (dexketoprofen) and low molecular weight heparin (LMWH) (bemiparin) in prophylactic doses in trauma and orthopedic patients. The study included patients who underwent trauma or orthopedic surgery and who received dexketoprofen and/or bemiparin in prophylactic doses. The main evaluation criteria were blood loss during and after surgery and the presence of major or clinically significant bleeding/hemorrhage. Secondary outcomes were: the need for transfusion of blood products, the need for drugs which have an impact on hemostasis and on changes in laboratory parameters.
There were no interactions between LMWH and NSAID that would significantly affect the coagulation parameters which are being used in routine clinical practice. Concomitant use of LMWH and NSAID increase the risk of small bleedings (odds ratio (OR) 0.23; 95% confidence interval (CI) [0.12–0.45]), but not major and clinically significant ones (OR 3.46; 95% CI [0.49–150.1]) in the postoperative period. Also, the combination of LMWH and NSAID does not increase postoperative wound bleeding, blood loss through surgical drainages and does not increase the number of blood transfusions.
It was found that co-administration of LMWH in prophylactic doses and NSAID can be used in trauma and orthopedic patients in the postoperative period.


Keywords


thromboprophylaxis; low molecular weight heparins; non-steroidal anti-inflammatory drugs; hemorrhagic complications

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DOI: https://doi.org/10.22141/1608-1706.5.15.2014.81744

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