Hemodynamic and Arterial Blood Gas Parameters during Cemented Hip Hemiarthroplasty in Elderly Patients

نویسندگان

1 2. Department of Anesthesiology, Associated professor, Guilan University of medical science, Rasht, Iran

2 Department of Anesthesiology, Assistant professor, Guilan University of medical science, Rasht, Iran

3 Department of Orthopedics, Assistant professor, Guilan University of medical science, Rasht, Iran

4 Department of Orthopedics, Assistant professor, Guilan University of medical science, Rasht, Iran

5 associated professor anesthesiology research center guilan university of medical sciences

6 Department of Orthopedics, Assistant professor, Guilan University of medical science, Rasht, Iran

doi
10.22038/abjs.2014.3232
چکیده

Background:  Patients undergoing cemented hip hemiarthroplasty may develop bone cement implantation syndrome (BCIS) which is a leading cause of intraoperative complications. The purpose of this study was to evaluate cardiovascular changes during cemented hip hemiarthroplasty in elderly patients.   Methods:  Cemented hip hemiarthroplasty was performed on 72 patients with femoral neck fracture. All patients were catheterized with a radial artery catheter to assess mean arterial pressure (MAP) and arterial blood gas (ABG) in these time points: just before cementation, just after cementation (0th), 5 min (5th) and 10 min (10th ) after cementation, and at the end of surgery (END). Also, systolic and diastolic blood pressure (SBP & DBP), heart rate and any arrhythmia or cardiac arrest was evaluated.  Results:  Seventy-two patients (33 females, 39 males; mean age: 66.8±7 years) were evaluated. All parameters changed during cementation with a significant drop in MAP, SBP, and DBP immediately after cementation and pH and base excess decreased significantly (P<0.001) with no changes in O2 saturation. Mean heart rate rose until the 5th and then decreased dramatically with no bradycardia presentation. During cementation, 12 patients showed arrhythmia, but no cardiac-arrest was observed.   Conclusions:  Under strict observation of a anesthesiology care team, hemiarthroplasty can be a safe method for femoral neck fracture in elderly osteoporotic patients without severe cardiopulmonary compromise.