Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia
BackgroundThe old age population, including the very old aged (≥ 85 years), is rapidly increasing, and femur neck fracture from accidents is commonly seen in the elderly. Use of bone cement during bipolar hemiarthroplasty can cause bone cement implantation syndrome.MethodsThis study was prospectivel...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2015-02-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kjae-68-37.pdf |
| _version_ | 1818135097198510080 |
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| author | Hye Jin Park Hyoseok Kang Jae-Woo Lee Seung Min Baek Jeong Seung Seo |
| author_facet | Hye Jin Park Hyoseok Kang Jae-Woo Lee Seung Min Baek Jeong Seung Seo |
| author_sort | Hye Jin Park |
| collection | DOAJ |
| description | BackgroundThe old age population, including the very old aged (≥ 85 years), is rapidly increasing, and femur neck fracture from accidents is commonly seen in the elderly. Use of bone cement during bipolar hemiarthroplasty can cause bone cement implantation syndrome.MethodsThis study was prospectively conducted on the elderly who were scheduled to undergo elective cemented bipolar hemiarthroplasty under spinal anesthesia. Patients were divided into 2 groups: the old age (65-84 years) and very old age groups (≥ 85 years). Hemodynamic parameters were recorded at the following time points: the start of the operation, femoral reaming, cement insertion, every 2 minutes after cement insertion for 10 minutes, femoral joint reduction, and the end of operation. When hypotension occurred, ephedrine was given.ResultsSixty-five patients in the old age group and 32 patients in the very old age group were enrolled. Mean ages were 78.9 and 89.4 years, respectively, in the old age and very old age groups. The very old age group showed constantly decreased levels of cardiac index and stroke volume from cementing until the end of the operation compared to the old age group. To maintain hemodynamic stability after cement insertion, the requirement of ephedrine was higher in the very old age group than in the old age group (13.52 ± 7.76 vs 8.65 ± 6.38 mg, P = 0.001).ConclusionsBone cement implantation during bipolar hemiarthroplasty may cause more prominent hemodynamic changes in very elderly patients. Careful hemodynamic monitoring and management are warranted in very elderly patients undergoing cemented bipolar hemiarthroplasty. |
| first_indexed | 2024-12-11T09:19:05Z |
| format | Article |
| id | doaj.art-c8a36be917894639b164a1f96039d560 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-11T09:19:05Z |
| publishDate | 2015-02-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-c8a36be917894639b164a1f96039d5602022-12-22T01:13:18ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632015-02-01681374210.4097/kjae.2015.68.1.378089Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesiaHye Jin Park0Hyoseok Kang1Jae-Woo Lee2Seung Min Baek3Jeong Seung Seo4Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.BackgroundThe old age population, including the very old aged (≥ 85 years), is rapidly increasing, and femur neck fracture from accidents is commonly seen in the elderly. Use of bone cement during bipolar hemiarthroplasty can cause bone cement implantation syndrome.MethodsThis study was prospectively conducted on the elderly who were scheduled to undergo elective cemented bipolar hemiarthroplasty under spinal anesthesia. Patients were divided into 2 groups: the old age (65-84 years) and very old age groups (≥ 85 years). Hemodynamic parameters were recorded at the following time points: the start of the operation, femoral reaming, cement insertion, every 2 minutes after cement insertion for 10 minutes, femoral joint reduction, and the end of operation. When hypotension occurred, ephedrine was given.ResultsSixty-five patients in the old age group and 32 patients in the very old age group were enrolled. Mean ages were 78.9 and 89.4 years, respectively, in the old age and very old age groups. The very old age group showed constantly decreased levels of cardiac index and stroke volume from cementing until the end of the operation compared to the old age group. To maintain hemodynamic stability after cement insertion, the requirement of ephedrine was higher in the very old age group than in the old age group (13.52 ± 7.76 vs 8.65 ± 6.38 mg, P = 0.001).ConclusionsBone cement implantation during bipolar hemiarthroplasty may cause more prominent hemodynamic changes in very elderly patients. Careful hemodynamic monitoring and management are warranted in very elderly patients undergoing cemented bipolar hemiarthroplasty.http://ekja.org/upload/pdf/kjae-68-37.pdfagedbone cementshemiarthroplastyhemodynamicsspinal anesthesia |
| spellingShingle | Hye Jin Park Hyoseok Kang Jae-Woo Lee Seung Min Baek Jeong Seung Seo Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia Korean Journal of Anesthesiology aged bone cements hemiarthroplasty hemodynamics spinal anesthesia |
| title | Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| title_full | Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| title_fullStr | Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| title_full_unstemmed | Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| title_short | Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| title_sort | comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia |
| topic | aged bone cements hemiarthroplasty hemodynamics spinal anesthesia |
| url | http://ekja.org/upload/pdf/kjae-68-37.pdf |
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