Korean J Anesthesiol.  1998 May;34(5):1002-1008. 10.4097/kjae.1998.34.5.1002.

Changes in Cardiopulmonary Variables during Cemented Hip Arthroplasty in the Elderly Patients

• Ko SH
• Kim DC
• Lee SK
• Han YJ
• Choe H
• Song HS

• KMID: 2237653
• DOI: http://doi.org/10.4097/kjae.1998.34.5.1002

Abstract

BACKGROUND: Bone cement implantation syndrome is characterized by hypotension, hypoxemia, cardiac arrhythmia, cardiac arrest, or any combination of these complications. The purpose of this study was to examine the effects of methylmethacrylate bone cement on cardiopulmonary variables during cemented hip arthroplasty in the elderly patients.
METHODS
Twenty patients, aged over 65, undergoing cemented hip arthroplasty under general anesthesia were evaluated. Various cardiopulmonary variables with pulmonary and radial artery catheter, analysis of arterial blood gases, and capnography were measured at pre- and post-prosthetic insertion.
RESULTS
The application of methylmethacrylate bone cement and femoral prosthesis resulted in an increase in pulmonary artery pressure and pulmonary vascular resistance, but there were no significant changes in blood pressure, heart rate, cardiac output, and systemic vascular resistance. Cemented hip arthroplasty was also associated with increased PaCO2 and dead space ventilation. Decreased PaO2 (1 atient) and hypotension (2 patients) were noted just after implatation of bone cement and prosthesis.
CONCLUSIONS
In conclusion, hip arthroplasty with methylmethacrylate bone cement is associated with substantial risk in the elderly patients. We make recommendations of measures for the prevention and the management against hypotension and hypoxemia during cemented hip arthroplasty in the elderly patients.

Keyword

Age factors: elderly; Complications: hypotension; hypoxemia; Surgery: hip arthroplasty; methylmethacrylate bone cement

MeSH Terms

Aged*
Anesthesia, General
Anoxia
Arrhythmias, Cardiac
Arthroplasty*
Blood Pressure
Capnography
Cardiac Output
Catheters
Gases
Heart Arrest
Heart Rate
Hip*
Humans
Hypotension
Methylmethacrylate
Prostheses and Implants
Pulmonary Artery
Radial Artery
Vascular Resistance
Ventilation
Gases
Methylmethacrylate