Is Lovenox Safe if Having Epidural for Tummy Tuck?

asked 2 years ago by kkmommy in atlanta, ga
Latest answer by Nina S. Naidu, MD
Question viewed 843 times
Tags: abdomen

I'm having abdominoplasty with epidural anesthesia in one week. My PS has given me Lovenox injections to administer daily after surgery to prevent DVT blood clots (he uses it routinely with all tummy tuck patients). However in the "Safety Information" section of the Lovenox guide it says "patients requiring epidural/spinal anethesia while being treated with Lovenox are at risk of developing a blood clot in or around the spine which may result in long-term or permanent paralysis."

Should I avoid using the Lovenox? I've put a call into my PS, but I'd like other opinions.

9 answers to Is Lovenox Safe if Having Epidural for Tummy Tuck?

Lovenox and tummy tuck

There is a risk with every medication, and you just need to be aware of the risk with an epidural. This a low risk, but it can happen. You should also speak with your plastic surgeon about this, as he may have an opinion based on his personal experience. Good luck, /nsn.

Nina S. Naidu, MD
New York Plastic Surgeon

I would be concern about epidural

If there is a medical reason for the epidural and not general anesthesia,then I would not use blood thinners till after surgery. The other option is to use Sequential Compression Device pre and post op.This will reduce the risk of DVT. I send home my patient with this device for the post op DVT prevention. I wonder what is the reason for epidural ? Why not general anesthesia?

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Use general anesthesia for tummy tuck with Lovenox.

Hi. I think using Lovenox after a tummy tuck is a great safety measure. But I would not use it together with epidural anesthesia. Why increase risk, by even a little?

George J. Beraka, MD
Manhattan Plastic Surgeon

Lovenox and epidurals

This is potentially dangerous, and I have been made aware of a number of cases of paralysis and law suits resulting from same. I would discuss this with the ps and anesthesia before starting Lovenox after epidural.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Lovenox safe if having epidural for tummy tuck.

I agree with both previous posters plus why are you having an epidural tummy tuck. That is very unusual so you must have a true reason, concern, or medical issue that you have not related to us in your posting. I would require a FULL medical clearance and in hospital stay before I would operate upon you. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Lovenox and tummy tuck

The fact that you are to administer the Lovenox beginning the day after sugery would make a complication from your epidural very unlikely. I would question the benefit as well, however, with this time frame. Most blood clots develop intraoperatively and most surgeons give Lovenox preop to decrease chances of DVT. I too use segmental pressure stockings and early ambulation.

John Whitt, MD
Louisville Plastic Surgeon

DVT prophylaxis

DVT is a rare but potentially serious problem that can follow a tummy tuck. In some patients the risk can be high and some form of prophylaxis is indicated. Some of us use prophylaxis in all patients. The question is what sort of prophylaxis should that be. Lovenox has a risk of bleeding and in each individual case this should be weighted against the risk of developing an unwanted clot. Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon

Post-Operative Blood Thinning and Epidural Anesthesia

I agree with Dr. Placik. It bears repeating that Medicine is an art and not an exact science and that risks and benefits must always be weighed. While thinning of the blood may protect us from clot formation it can promote serious post-operative bleeding which can require re-operation on in the case of spine surgery bleeding and compression of the spinal cord. I would suggest you go over this point with your plastic surgeon. He may wish to change your method of anesthesia. Personally, I use... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Risk of Clot versus Risk of bleeding with Lovenox

This is possible if the lovenox is given prior to surgery but the risks are low and ultimately it comes down to risk assessment and risk tolerance. You have to weigh the advantages of preventing a blood clot if treated and the risks of bleeding into the spine and developing paralysis against the possibiltiy of having a blood clot which may be fatal if it travels to the heart and lungs.