To Evaluate The Efficacy Of Prophylaxis Against Deep Vein Thrombosis With Peroperative Electro-Stimulation Of Calf Muscles In Patients Undergoing Surgery Around The Hip Joint
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 1
Abstract
Background: The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). Various measures available for DVT prophylaxis, include early mobilization, physiotherapy, pharmacological and mechanical. The stimulation of calf muscle during surgery may help in preventing DVT. Despite a great deal of research, DVT continues to pose a major threat to patients undergoing major surgeries. There is still controversy concerning the best prophylactic regimen. Therefore, the objective of the study was to evaluate the role of peroperative calf muscle electro-stimulation in prevention of DVT in patients undergoing surgery around the hip joint and to compare the incidence of deep vein thrombosis with control group operated without peroperative calf muscle stimulation. Materials and Methods: This study was conducted on 60 patients undergoing surgery around the hip joint under spinal anaesthesia, and operated at SGRD Hospital, Vallah, Amritsar, in the Department of Orthopaedic Surgery, during the period from December 2013 to June 2015. Prior ethical approval from Institutional Ethical Committee was obtained. Established cases of DVT, or patients taking antithrombotic medication, patient who sustained open fractures, and patients on pacemakers was excluded from the study. All the consenting patients were randomized into two groups: 30 cases were given Peroperative calf muscle electro-stimulation for deep vein thrombosis prophylaxis (Group A) and the remaining 30 patients were taken as control without any prophylaxis (Group B).The Color Doppler Ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups. Results and Conclusions:We observed that no patients among Group A and two patients among Group B demonstrated DVT on ultrasonography, this difference was not found to be statistically significant (P=.05). Patients who were postTHA/TKA find the application of calf muscle electrostimulation comfortable and acceptable as a treatment. The role of peroperative calf muscle electro-stimulation for DVT prophylaxis remains controversial, but we conclude that the use of calf muscle electrostimulation on postoperative orthopaedic patients can be safely considered as a DVT prevention method. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our groups.
Authors and Affiliations
Deepak Kumar Agrawal
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