Abstract:
BACKGROUND:The "bone cement implantation syndrome" is a rare but severe complication observed especially during the insertion of cemented prostheses in hip and knee replacement surgery. Several mechanisms are involved: effects of methylmethacrilate, embolism of fat, air and bone marrow, and release of tissue thromboplastin during acetabular and femoral reaming. Aim of this study was to detect embolic events, right heart impairment, hemodynamic and respiratory changes during hip and knee replacement surgery. METHODS: DESIGN:Prospective study, between February-May 2001. ENVIRONMENT:Orthopedic Operative room. PATIENTS:Twenty-one patients who underwent total hip or knee arthroplasty under general anesthesia. Patients were divided in methylmethacrylate cemented prostheses groups (CEM, n=10) and totally uncemented prostheses (NON CEM, n=11). DATA COLLECTION:Standard anesthesia monitoring and omniplane TEE were performed. TEE probe was positioned in order to obtain "inflow-outflow" views of right heart. Measurements were obtained after anesthesia induction (T1), during femoral realing (T2) at prostheses insertion (T3), and at the end of surgery (T4). RESULTS:Hemodynamic and respiratory parameters measured in different phases of surgical procedures were not different within groups and between groups. Fourtheen patients had TEE evidence of emboli, and the phenomenon was more evident in CEM group (Z= -347; p<0.001). During prostheses insertion, a slight, not significant increase in right ventricular dimensions was observed in both groups, without any right ventricular wall kinetic abnormality. No difference was observed between groups. No adverse cardiac or cerebrovascular events in intra- and postoperatory period were observed. CONCLUSIONS:In normal patients total hip or knee arthroplasty is associated with embolic phenomena, without any significant change in systemic and right heart hemodynamics. Insertion of cemented prostheses does not modify hemodynamic profile. It remains to be elucidated if the occurrence of emboli has a critical role in patients with cardiorespiratory disease.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Dambrosio M,Tullo L,Moretti B,Patella V,Simone C,Calò MN,Dalfino L,Cinnella Gkeywords:
subject
Has Abstractpub_date
2002-06-01 00:00:00pages
537-47issue
6eissn
0375-9393issn
1827-1596journal_volume
68pub_type
临床试验,杂志文章abstract::The successful management of a case of primary hypothyroidism, who underwent hemicolectomy, is described. Anaesthesia was induced with TPS and maintained with only isoflurane. Neuromuscular blockade was achieved by atracurium. Hemodynamic, respiratory and neuromuscular monitoring was performed. This complex intraopera...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
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journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 评论,信件
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-11-01 00:00:00
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pub_type: 杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
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更新日期:2014-10-01 00:00:00
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journal_title:Minerva anestesiologica
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pub_type: 杂志文章
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