[High incidence of cardiorespiratory deterioration in patients receiving cemented hip hemiarthroplasty for femoral neck fracture].
BACKGROUND
Anesthesia for patients who undergo surgery for femoral neck fractures can be associated with severe cardiopulmonary complications.


METHODS
We retrospectively studied 361 consecutive patients who underwent surgery for femoral neck fractures. Dividing patients into three groups according to type of surgery-hip hemiarthroplasty (n=134), compression hip screw (n=123) or gamma nail (n=104)--we calculated the incidences of cardiorespiratory deterioration during anesthesia and examined factors associated with it.


RESULTS
Among hemiarthroplasty patients, six (4.5%) encountered cardiorespiratory deterioration; four (3.0%) experienced profound hypotension, bradycardia or cardiac arrest immediately after implantation of the bone cement or insertion of the prosthesis into the femoral bone; and two (1.5%) developed hypoxia and angina pectoris during the late phase of surgery. Patients who underwent compression hip screw or gamma nail had no cardiorespiratory deterioration. No difference was found in patient characteristics or type of anesthesia used among the three surgery groups. Time of surgery and amount of blood loss both were significantly greater in patients undergoing hemiarthroplasty.


CONCLUSIONS
The surgical techniques selected for hip hemiarthroplasty, which is associate with an increase in intramedullary pressure, may be a significant risk factor for cardiorespiratory deterioration from anesthesia in patients undergoing surgery for femoral neck fracture.
Yamada
Tomoko
T
Department of Anesthesiology, Critical Care and Pain Medicine, National Hospital Organization Kure Medical Center.
Momwaki
Katsuyuki
K
Shmroyama
Kazuhisa
K
Ohtani
Tomota
T
Sakai
Akihiko
A
Miki
Tomoaki
T
Kobayashi
Masako
M
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D001843:Bone Cements / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
D001843:Bone Cements