Abstract
In the evening of the first postoperative day, the patient is started on anticoagulants, usually Coumadin at the dose of 10 mg unless the person has demonstrated previously sensitivity to the drug and may, therefore, need smaller amounts. At least 5 mg should be given orally that same evening. Also, the patient is started on oral Plavix (Clopidogrel), 75 mg daily. Lovenox is given subcutaneously at the dose of 40 mg bid for the first 48 h until the INR, which monitors the level of Coumadin reaches therapeutic levels (INR 2–3). The Dextran 40 which was started in surgery should also be continue at a rate of 15 cc per hour during the 48 h required for the Coumadin therapy to take effect [1]. No intravenous heparin is prescribed at any time and the patient is monitored with daily INR thereafter for the following 8–12 weeks (Table 25.1).
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References
Frost-Arner L, Bergquist D. Effects of heparin desmopressin, and isovolemic hemodihition with dextran on thrombus formation in synthetic vessel grafts inserted into the vena cava of the rabbit. J Vasc Surg. 1998;28:506–13.
Schulman S, Kearon C, Kakkar AK, et al. Dabigatran versus Warfarin in the treatment of acute venous thromboembolism. N Eng J Med. 2009;361:2342–52.
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Molina, J.E. (2013). Postoperative Care: Anticoagulants, Pain Control, and Nursing Care. In: New Techniques for Thoracic Outlet Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5471-7_25
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DOI: https://doi.org/10.1007/978-1-4614-5471-7_25
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