Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

Xi Yu; Yi Tian; Ka Wang; Ying-Lin Wang; Guo-Yi Lv; Guo-Gang Tian

doi:10.1016/S1995-7645(14)60162-0

Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

Asian Pac J Trop Med. 2014 Nov;7(11):918-21. doi: 10.1016/S1995-7645(14)60162-0. Epub 2014 Oct 22.

Authors

Xi Yu¹, Yi Tian², Ka Wang², Ying-Lin Wang², Guo-Yi Lv³, Guo-Gang Tian⁴

Affiliations

¹ Department of Anesthesiology, 2nd hospital of Tianjin Medical University, Tianjin 300211, China; Department of Anesthesiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, China.
² Department of Anesthesiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, China.
³ Department of Anesthesiology, 2nd hospital of Tianjin Medical University, Tianjin 300211, China.
⁴ Department of Anesthesiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, China. Electronic address: dr_tgg@126.com.

PMID: 25441995
DOI: 10.1016/S1995-7645(14)60162-0

Abstract

Objective: To explore the effect of ulinastatin (UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.

Methods: Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took Rivaroxaban 10 mg orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preoperatively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of surgery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombomodulin (TM), Interleukin (IL-6), thrombin-antithrombin complex (TAT), D-Dimer (D-D) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery.

Results: Compared with T1, there was an upward tendency in TM, IL-6, TAT, and D-D after operation in group C group (P<0.05). The values of them were significantly increased from nearly 24-hour after surgery in Us group (P<0.05). In group Uc, there were no significant changes in these indices after operation (P>0.05).

Conclusions: During the perioperative period, ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.

Keywords: DVT; Orthopedic surgery; Rivaroxaban; Ulinastatin.