Year: 1989
Type: article
Study design: Case Report
Abstract: Bone cementInsertion of bone cement into the femoral shaft during total hip replacement often produces hypotension and hypoxaemia.Other reported adverse reactions include cardiac arrhythmias, myocardial infarction, cardiac arrest, pulmonary embolism and cerebrovascular accident.Bronchospasm should be added to this list after the occurrence of this complication in an obese 79-year-old-woman with a long history of asthma, who had a replacement arthroplasty of her right hip as an elective procedure.Her asthma was treated for 4 days before surgery with nebulised salbutamol and oral prednisolone 10 mg, four times a day, which caused improvement in her condition.She was premedicated with temazepam 20 mg orally and anaesthesia was induced with propofol 150 mg and fentanyl 350 pg.Vecuronium 8 mg was given and her trachea intubated with a short tracheal tube and her lungs ventilated with 66% nitrous oxide, 33% oxygen and 1% enflurane.Surgery progressed well, the acetabular component was cemented in place without incident until insertion of the femoral shaft cement.The peak inflation pressure increased from 2.4 to 4.5 kPa within seconds and marked bilateral wheeze was evident on auscultation of her chest.She remained well perfused with no change in pulse rate or blood pressure; there was no oedema.The bronchospasm responded to intravenous aminophylline 250 mg given over 5 minutes followed by an infusion of 40 mg/hour.Her subsequent recovery was uneventful.The bone cement used was Palacos R with Gentamicin (Kirby-Warrick) which is supplied as a powder and liquid which, when mixed, form a paste which is injected between
Source: Anaesthesia
Author: J.M. Slade
Institution: Royal Hallamshire Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4252832004