Anesthesia and Venous Thromboembolism
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Excerpt
To the Editor.— The recent CONSENSUS CONFERENCE entitled "Prevention of Venous Thrombosis and Pulmonary Embolism"1 is an admirable review of what is known concerning perioperative risk and management of a potentially life-threatening complication. It may interest the authors and readers, however, to learn that the choice of anesthetic may have a significant influence on the development of thromboembolic complications in surgical patients.
Several authors2-5 have investigated the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing hip surgery or prostatectomy and receiving either general or regional anesthesia (spinal or epidural). In patients receiving general anesthesia, venous thromboses were detected by iodine 125-fibrinogen scanning or phlebography in 51% to 77%. Clinically identifiable pulmonary emboli were evident in 33% to 47%. In comparison groups of patients receiving regional anesthesia, the incidence of DVT and PE fell to 12% to 40% and 10% to 13%, respectively. In
