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June 15, 1984

Deep Venous Thrombosis in Total Hip Replacement

Author Affiliations

McFarland Clinic, PC Ames, Iowa

JAMA. 1984;251(23):3081. doi:10.1001/jama.1984.03340470017012

To the Editor.—  I refer to the recent article by Sautter et al1 entitled "Aspirin-Sulfinpyrazone in Prophylaxis of Deep Venous Thrombosis in Total Hip Replacement." As the authors point out, thromboembolism is a common complication of hip arthroplasty and is, in fact, a major cause of postoperative mortality in these patients. They further note and support from their data a statistically significant reduction of venographically diagnosed thrombi in the proximal veins of the leg in patients treated with aspirin and sulfinpyrazone. They further recognized at least four factors that might have influenced the development of thrombus and confounded the results of prophylactic treatment. These factors included risk factors predisposing development of thrombosis, sex, postoperative wearing of stockings, and ABO blood type.I would like to add an additional factor that the authors neglected to address in their article. The choice of anesthetic technique, regional (spinal and epidural) v general

Sautter RD, Koch EL, Myers WO, et al:  Aspirinsulfinpyrazone in prophylaxis of deep venous thrombosis in total hip replacement .  JAMA 1983;250:2649-2654.Crossref
Salzman EW, Harris WH:  Prevention of venous thromboembolism in orthopaedic patients .  J Bone Joint Surg Am 1976;58:903-913.
Modig J, Borg T, Karlstrom G, et al:  Thromboembolism after total hip replacement: Role of epidural and general anesthesia .  Anesth Analg 1983;62:174-180.Crossref
Davis FM, Quince M:  Deep vein thrombosis and anaesthetic technique in emergency hip surgery .  Br Med J 1980;281:1528-1529.Crossref
Thornburn R, Louden JR, Vallance R:  Spinal and general anaesthesia in total hip replacement: Frequency of deep vein thrombosis .  Br J Anaesth 1980;52:1117-1121.Crossref