HEMODYNAMIC AND RESPIRATORY CHANGES DURING CEMENTATION IN HIP ARTHROPLASTY
Şebnem ATICI1, Volkan ÖZTUNA2, Nurcan DORUK1, Hasan SERİNOL1, Fehmi KUYURTAR2, Uğur ORAL1
1Mersin Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı
2Mersin Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı
Keywords: Cement, Compleman, Hypoxia, Hypotension, Hip Arthroplasty.
Abstract
Introduction: In this study, the changes in haemodynamic and respiratory parameters during cementation in hip arthroplasty were documented and the possible causes were investigated.
Patients and methods: Fifteen patients (ASA III risk group) with a mean age of 65 years (52-78) were included. Thiopental sodium (5 mg/kg) and Vecuronium bromide (0.1 mg/kg) were used for induction and sevoflurane 2% and 66% N20 +33% 02 for maintenance of anaesthesia. Radial artery cannulation was performed. Blood gases, end tidal CO2, systolic and diastolic blood pressure values were obtained before and at 1, 5, 10,15 and 30th minutes after cement implantation. Prothrombin time, partial thromboplastin time, fibrinogen, C3, C4 values were measured before and at 30th minutes after the cementation.
Results: Significant decreases in systolic and diastolic blood pressures were detected at 10, 15 and 30th minutes after cementation (p<0.05). pH found to be decreased at 10, 15, 30th minutes after cementation compared to baseline values (p<0.05). Significant increases were recorded in PaCO2 at 1, 5, 10, 15 and 30th minutes and in ETCO2 at 30th minutes after cementation compared to baseline values (p<0.05). PaO2 was significantly decreasing at 5, 10, 15 and 30th minutes after cementation. C3 and C4 levels were found to be decreased after cementation (p<0.05). There was no significant difference in prothrombin time, partial thromboplastin time and fibrinogen.
Discussion: Changes in blood pressure and blood gases during cementation may occur due to cement toxicity and/or the procedure. These changes should be taken into consideration when choosing the method of anaesthesia and type of surgical intervention in high-risk patients.