Bhadani Janki Sharan, Kumar Indrajeet, Ahmed Wasim, Kumar Santosh, Kumar Alok
Department of Orthopaedics, Paras HMRI Hospital, Patna 14, India.
Department of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, India.
J Orthop Case Rep. 2024 Aug;14(8):212-221. doi: 10.13107/jocr.2024.v14.i08.4702.
Bone cementation has various effects on hemodynamics including potentially fatal bone cement implantation syndrome (BCIS). Most of the studies on BCIS are from developed countries. We have studied the effect of bone cement on hemodynamics in hip arthroplasty in the eastern Indian population and compared it with the available literature.
This prospective study was done by a team of orthopedic surgeons and anesthesiologists in a tertiary center in eastern India between March 2020 and December 2022.
Seventy-two patients (Male 38: and Female 34) of age between 25 and 100 years fulfilling the inclusion criteria were included. In 43 patients (43/72, 59.72%) systolic and diastolic blood pressure fell in the range of 10 mmHg, in 22 patients (22/72, 30.56%) fall in blood pressure was in the range of 10-20 mmHg, and more than 20 mmHg fall in blood pressure were seen in seven patients (7/72, 9.72%). SPO2 decreased from 97-100% to 94-96% in 28 patients and 90-93% in six patients, which began to rise after 5 min of cementing and returned to normal after 10 min. Arrhythmias were seen in 16 patients with multiple comorbidity. Two patients had a cardiac arrest and one patient died after 6 h in the intensive care unit.
Pre-operative evaluation, perioperative monitoring of hemodynamic parameters during cementing especially in high-risk patients with multiple comorbidities, and taking essential precautions during cemented arthroplasty are the key to preventing complications like BCIS.
骨水泥固定对血流动力学有多种影响，包括潜在致命的骨水泥植入综合征（BCIS）。大多数关于BCIS的研究来自发达国家。我们研究了骨水泥对印度东部人群髋关节置换术中血流动力学的影响，并与现有文献进行了比较。
这项前瞻性研究由印度东部一家三级中心的骨科医生和麻醉医生团队于2020年3月至2022年12月期间完成。
纳入了72例年龄在25至100岁之间符合纳入标准的患者（男性38例，女性34例）。43例患者（43/72，59.72%）的收缩压和舒张压下降幅度在10 mmHg范围内，22例患者（22/72，30.56%）的血压下降幅度在10 - 20 mmHg范围内，7例患者（7/72，9.72%）的血压下降超过20 mmHg。28例患者的SPO2从97 - 100%降至94 - 96%，6例患者降至90 - 93%，在骨水泥固定5分钟后开始上升，10分钟后恢复正常。16例患有多种合并症的患者出现心律失常。2例患者发生心脏骤停，1例患者在重症监护病房6小时后死亡。
术前评估、骨水泥固定期间血流动力学参数的围手术期监测，尤其是在患有多种合并症的高危患者中，以及在骨水泥固定关节置换术中采取必要的预防措施是预防BCIS等并发症的关键。
