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Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study.

Publication ,  Journal Article
Constantini, S; Kanner, A; Friedman, A; Shoshan, Y; Israel, Z; Ashkenazi, E; Gertel, M; Even, A; Shevach, Y; Shalit, M; Umansky, F; Rappaport, ZH
Published in: J Neurosurg
June 2001

OBJECT: Thromboembolic phenomena (TEPs) continue to be a significant source of morbidity and mortality in patients undergoing neurosurgery. Although the efficacy of low-dose heparin in preventing TEPs in neurosurgical patients is well established, neurosurgeons are reluctant to use it perioperatively because of concern for increased bleeding complications. To clarify this issue, the authors used a prospective, randomized, double-blind design to evaluate the safety of minidose heparin treatment in patients undergoing surgery for supratentorial brain tumors. METHODS: One hundred three patients, all 40 years of age or older, were treated with either 5000 U of heparin (55 patients) or placebo (48 patients) starting 2 hours before surgery and continuing until full mobilization or for 7 days. Both groups were well matched for sex, weight, duration of surgery, and tumor diagnosis. Subjective and objective parameters were used to estimate and calculate the perioperative bleeding tendency in all patients. Red blood cell mass loss was calculated by assessing the preoperative and postoperative hematocrit and the patient's weight. Intraoperative blood loss was determined by measuring the quantity of blood in the suction containers and subtracting the amount of irrigation fluids. Postoperative bleeding was measured by determining the amount of fluid in the subgaleal drain, and blood cell replacement was monitored during and after the procedure. Intracranial bleeding was graded according to findings on the postoperative computerized tomography scan obtained 48 to 72 hours after surgery. In addition, the senior surgeon in each case was asked to assess each patient's bleeding tendency during the operation. The results showed that perioperative administration of heparin did not significantly alter bleeding tendency by any measured parameter. The surgeon was blinded to which group individual patients had been allocated. CONCLUSIONS: Perioperative minidose heparin is safe for use in patients undergoing craniotomy for supratentorial tumors. This relatively simple and inexpensive measure is recommended as a routine regimen for the prevention of TEPs in patients undergoing neurosurgery.

Duke Scholars

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

June 2001

Volume

94

Issue

6

Start / End Page

918 / 921

Location

United States

Related Subject Headings

  • Supratentorial Neoplasms
  • Safety
  • Prospective Studies
  • Preoperative Care
  • Postoperative Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intraoperative Care
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Constantini, S., Kanner, A., Friedman, A., Shoshan, Y., Israel, Z., Ashkenazi, E., … Rappaport, Z. H. (2001). Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study. J Neurosurg, 94(6), 918–921. https://doi.org/10.3171/jns.2001.94.6.0918
Constantini, S., A. Kanner, A. Friedman, Y. Shoshan, Z. Israel, E. Ashkenazi, M. Gertel, et al. “Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study.J Neurosurg 94, no. 6 (June 2001): 918–21. https://doi.org/10.3171/jns.2001.94.6.0918.
Constantini S, Kanner A, Friedman A, Shoshan Y, Israel Z, Ashkenazi E, et al. Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study. J Neurosurg. 2001 Jun;94(6):918–21.
Constantini, S., et al. “Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study.J Neurosurg, vol. 94, no. 6, June 2001, pp. 918–21. Pubmed, doi:10.3171/jns.2001.94.6.0918.
Constantini S, Kanner A, Friedman A, Shoshan Y, Israel Z, Ashkenazi E, Gertel M, Even A, Shevach Y, Shalit M, Umansky F, Rappaport ZH. Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study. J Neurosurg. 2001 Jun;94(6):918–921.

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

June 2001

Volume

94

Issue

6

Start / End Page

918 / 921

Location

United States

Related Subject Headings

  • Supratentorial Neoplasms
  • Safety
  • Prospective Studies
  • Preoperative Care
  • Postoperative Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intraoperative Care
  • Humans