Non-orthopedic Surgery VTE Prophylaxis

Question 1

General Surgery VTE Prophylaxis agents

Answer 1

UFH and LMWHs show comparative efficacy in preventing DVT, but a greater reduction in the incidence of PE when an LMWH is used.

Question 2

Neurosurgery VTE Prophylaxis timing

Answer 2

typically started 18–24 hours after neurosurgery

Question 3

Gynecologic surgery VTE Prophylaxis

Answer 3

Low-risk gynecologic surgery procedures (laparoscopic procedures or procedures lasting less than 30 minutes) do not require prophylaxis beyond early ambulation. Those undergoing major surgery should receive UFH or an LMWH

Question 4

Gynecologic cancer surgery VTE Prophylaxis

Answer 4

UFH three times daily is more effective than twice daily. UFH three times daily and an LMWH seem to have similar efficacy and safety

Question 5

Unfractionated Heparin VTE Prophylactic Dose in Non-orthopedic Surgery

Answer 5

5000 units SC q8hr (recommended in neurosurgery/bariatric) or 5000 units SC q12hr

Question 6

Enoxaparin VTE Prophylactic Dose in Non-orthopedic Surgery

Answer 6

40 mg SC q24hr
Bariatric - 40 mg SC q12hr

Question 7

Dalteparin VTE Prophylactic Dose in Non-orthopedic Surgery

Answer 7

5000 IU SC q24hr
Bariatric - 7500 IU SC q24hr
No recommendation in neurosurgery

Question 8

Fondaparinux VTE Prophylactic Dose in Non-orthopedic Surgery

Answer 8

2.5 mg SC q24hr
Bariatric - 5 mg SC q24hr
No recommendation in neurosurgery or CABG

Question 9

Major general surgery Duration of VTE Prophylaxis

Answer 9

Until hospital discharge
patients with previous VTE -Beyond hospital discharge for up to 28 days

Question 10

Surgery for gastrointestinal, GU, or gynecologic cancer Duration of VTE Prophylaxis

Answer 10

Beyond hospital discharge for up to 28 days