Abstract
Background
Cement implantation syndrome characterized by hypotension, hypoxemia, cardiac arrhythmia or arrest has been reported in the literature. The purpose of the present study was to monitor blood pressure soon after cementing.
Methods
The present study includes 178 cases 204 joints of primary THA with an average age at operation of 64.5 years old (ranging 35 to 89). Under general anesthesia, both components were cemented using antero-lateral approach. Systolic arterial blood pressure during cementing acetabular and femoral components was monitored until 5 minutes with 1 minute interval. The maximum regulation ratio (MRR) was calculated as (maximum change blood pressure – blood pressure before cement insertion) divided by blood pressure before cement insertion.
Results
No major complications such as cardiac arrest were observed. In most of the cases, blood pressure increased until 4 minutes for the acetabular side and 2 minutes for the femoral side, and then returned to the blood pressure before cement insertion gradually. In the acetabular side, average MRR was 11.2% (SD, 15.9; range, −26 to 80). Ｉn the femoral side, MRR was 6.4% (SD, 14.9; range, −31 to 65). There was statistical correlation between categories of MRR in the acetabular side and age at operation, the status of bleeding control of the acetabular side. When the bleeding control was judged as complete, blood pressure showed less tendency to decrease. When the bleeding control was judged as good, blood pressure showed more tendency to decrease.
Conclusion
In the present study, major hypotension was not observed. Using third generation and IBBC cementing technique, when the bleeding control was judged as complete in the acetabular side, blood pressure showed less tendency to decrease.
