Thromboembolic prophylaxis with dihydroergotamine-heparin in abdominal surgery. A controlled, randomized study.

The prophylactic affect of dihydroergotamine-heparin (0.5 mg dihydroergotamine plus 5,000 units of heparin administered twice daily) against postoperative thromboembolic complications after gastrointestinal surgery was compared with the affect of 5,000 units of heparin administered three times daily in a controlled, randomized study. Fifty patients received the dihydroergotamine and heparin combination twice daily and 50 patients received 5,000 units of heparin three times daily. The two groups were comparable with respect to age, sex, body weight, and type of operation. The presence or absence of deep venous thrombosis in the legs was determined postoperatively by the radiofibrinogen uptake test. The frequency of deep venous thrombosis in the dihydroergotamine and heparin group was 12 percent compared with 18 percent in the heparin group (0.1 greater than p greater than 0.05). Wound hematoma developed in two patients in the heparin group and in one patient in the dihydroergotamine and heparin group (4 and 2 percent, respectively). No other hemorrhagic complications occurred. By combining heparin with dihydroergotamine it is possible to reduce the daily heparin dose by one third and still obtain the same level of prophylaxis against thromboembolism. The frequency of bleeding complications was very low in both groups, since only one wound hematoma occurred in the dihydroergotamine and heparin group and two in the heparin group.