Results of a German multicentre study show that a single daily dose of the new low molecular weight heparin, enoxaparin (2Omg), is safe and effective for the prophylaxis of thromboembolic complications in patients undergoing general surgical procedures. 'Ibis is the case regardless of whether it is given in the morning or evening.

In the study, patients undergoing elective abdominal, gynaecological and urological surgery received SC enoxaparin 20mg for 7 days, either in the morning, starting 2 hours before surgery (n = 4987), or in the evening (4920), beginning on the evening prior to surgery.

The overall incidences of fatal and nonfatal pulmonary embolism during enoxaparin therapy were 0.21 and 0.03%, respectively, indicating that the agent is at least as effective as low-dose heparin. And the incidence of deep vein thrombosis was 0.11%. The incidence of pulmonary embolism and deep vein thrombosis did not differ between groups.

Furthermore, the incidence of bleeding complications or other adverse events did not differ between morning and evening groups, and these adverse events were not any different from those associated with heparin. Haas s. FIoIbech CWo Pn:veolion of postopenIive duomboembolism with enoX8pllrin in general surpry: a German multic:enta' 1riaI. Seminars in Thrombosis 8IId Hemostasis 19 (SuppL 1): 164-173. 1993 III02D9<T7

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