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


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.


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


Nalini Vadivelu, Sukanya Mitra, Deepak Narayan. Recent Advances in Postoperative Pain Management // Yale Journal of Biology and Medicine. — 2010. — Vol. 83. — P. 11-25.

Simon L. Nonsteroidal anti-inflammatory drugs and their risk: a story still in development // Arthritis Research & Therapy. — 2013. — Vol. 15(Suppl. 3). — S1.

Green D., Klement P., Liao P., Weitz J. Interaction of low molecular weight heparin with ketorolac // The Journal of Laboratory and Clinical Medicine. — 1996. — Vol. 127 (6). — P. 583-587.

Klinkhardt U., Breddin H., Esslinger H., Haas S., Kalatzis A., Harder S. Interaction between the LMWH reviparin and aspirin in healthy Volunteers // Br. J. Clin. Pharmacol. — 2000. — Vol. 49. — P. 337-341.

Dahl V., Raeder J. Combination of low molecular weight heparin and non-steroidal anti-inflammatory agents // Tidsskr Nor Laegeforen. — 1995. — Vol. 30 (115(14)). — P. 1728-30.

Запорожан В.Н., Тарабрин О.А., Суслов В.В. и др. Эффективность и безопасность применения Дексалгина и Цибора у больных, перенесших миомэктомию // Здоровье женщины. — 2011. — № 3. — С. 118-122.

Тарабрин О.А., Симовских А.В. Профилактика венозных тромбоэмболитических осложнений на этапах хирургического лечения у больных доброкачественной гиперплазией предстательной железы с сопутствующей артериальной гипертензией // Український журнал екстремальної медицини імені Г.О. Можаєва. — 2002. — № 2. — С. 67-73.

Тарабрин О.А., Мазур В.Н., Симовских А.В. Некоторые вопросы диагностики расстройств гемостаза и прогноз развития тромбогеморрагических осложнений у беременных с преэклампсией. Регионарная анестезия с позиции оценки коагулопатий // Біль, знеболювання та інтенсивна терапія. — 2007. — № 3. — С. 42-48.

Pannucci C., Bailey S. et al. Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients // J. Am. Coll Surg. — 2011. — Vol. 212(1). — P. 105-112.



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