Cardiovascular effects of polymethylmethacrylate in percutaneous vertebroplasty

doi:10.3969/j.issn.2095-4344.2014.21.017

Abstract

Abstract:

BACKGROUND: The study on polymethylmethacrylate effects on the cardiovascular system during percutaneous vertebroplasty is limited.
OBJECTIVE: To estimate the effects of polymethylmethacrylate on the cardiovascular system during percutaneous vertebroplasty.
METHODS: From July 2011 to September 2013, a total of 104 patients (167 vertebral bodies) with osteoporotic vertebral compression fractures and without serious cardiovascular related basic diseases were enrolled in this retrospective study. Mean arterial pressure, heart rate and oxygen saturation were recorded at the following time points: before local anesthesia, before polymethylmethacrylate injection, 0, 3, 5 and 10 minutes after polymethylmethacrylate injection.
RESULTS AND CONCLUSION: The mean arterial pressure was decreased after polymethylmethacrylate injection at 0, 5 minutes (P < 0.05) and 3 minutes (P < 0.01), and returned to the pre-injection level at 10 minutes. At the same time, the heart rate was increased after polymethylmethacrylate injection at 0, 5 minutes (P < 0.05) and 3 minutes (P < 0.01), and returned to the pre-injection level at 10 minutes. Oxygen saturation was over 95%, which was unchanged before and after polymethylmethacrylate injection. The results indicated that polymethylmethacrylate injection has a transient effect on cardiovascular system during percutaneous vertebroplasty.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: vertebroplasty, methylmethacrylates, heart rate, blood pressure

CLC Number:

R318

Song Qi-zhi, Li Tao, Feng Cheng-bin, Lin Ya-jun, Hong Hao. Cardiovascular effects of polymethylmethacrylate in percutaneous vertebroplasty[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(21): 3374-3379.

Figures/Tables 3

References

[1]Schuh FT,Schuh SM,Vicueba MC,et al.Circulatory changes following implantation of methylmethacrylate bone cement. Anesthesiology.1973;39(4):455-457.
[2]Convery RF,Gunn DR,Hughes JD,et al.The relative safety of polymethylmethacrylate: a controlled clinical study of randomly selected patients treated with Charnley and Ring total hip replacements.J Bone Joint Surg.1975;57(1):57-64.
[3]Pitto RP,Koessler M.The risk of fat embolism during cemented total hip replacement in the elderly patient.Chir Organi Mov. 1999;84(2):119-128.
[4]Pitto RP,Hamer H,Fabiani R,et al. Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial.J Bone Joint Surg Am. 2002;84-A(1):39-48.
[5]Duncan JAT.Intra-operative collapse or death related to the use of acrylic cement in hip surgery. Anaesthesia. 1989; 44(2):149-153.
[6]Ereth MH,Weber JG,Abel MD,et al.Cemented vs. noncemented total hip arthroplasty: embolism, hemodynamics, and intrapulmonary shunting.Mayo Clin Proc.1992; 67(11):1066-1074.
[7]Wong HY,Vidovich MI.Acute bronchospasm associated with polymethylmethacrylate cement. Anesthesiology. 1997;87(3): 696-698.
[8]Donaldson AJ,Thomson HE,Harper NJ,et al.Bone cement implantation syndrome.Br J Anaesth.2009;102(1):12-22.
[9]Rudigier JFM,Ritter G.Pathogenesis of circulatory reactions triggered by nervous reflexes during the implantation of bone cements.Res Exp Med (Berl).1983; 183(2):77-94.
[10]Khanna G,Cernovsky J.Bone cement and the implications for anaesthesia . Continuing Education in Anaesthesia.Critical Care Pain.2012;12(4):213-216.
[11]Jensen ME,Evans AJ,Mathis JM,et al.Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects.AJNR Am J Neuroradiol.1997;18(10):1897-1904.
[12]Padovani B,Kasriel O,Brunner P,et al.Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.AJNR Am J Neuroradiol.1999; 20(3):375-377.
[13]Vasconcelos C,Gailloud P,Martin JB,et al.Transient arterial hypotension induced by polymethylmethacrylate injection during percutaneous vertebroplasty.J Vasc Interv Radiol. 2001;12(8):1001-1002.
[14]宋奇志.经皮椎体后凸成形术治疗脊柱骨质疏松性压缩骨折的疗效和安全性观察[J].临床和实验医学杂志, 2012,11(17): 1366-1368.
[15]Barr JD,Barr MS,Lemley TJ,et al.Percutaneous vertebroplasty for pain relief and spinal stabilization.Spine (Phila Pa 1976).2000;25(8):923-928.
[16]Greenberg M.Handbook of Neurosurgery.6thed.New York: Thieme Publishing Group, 2005.
[17]Kanis JA.Diagnosis of osteoporosis and assessment of fracture risk.Lancet. 2002;359(9321):1929-1936.
[18]Cummings SR,Melton LJ.Epidemiology and outcomes of osteoporotic fractures. Lancet.2002;359(9319):1761-1767.
[19]Kado DM,Browner WS,Palermo L,et al.Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group.Arch Intern Med. 1999;159(11):1215-1220.
[20]Bostrom MP,Lane JM.Future directions: Augmentation of osteoporotic vertebral bodies.Spine (Phila Pa 1976). 1997; 22(24 Suppl):38S-42S.
[21]Fourney DR,Schomer DF,Nader R,et al.Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients.J Neurosurg. 2003; 98(1Suppl): 21-30.
[22]McKiernan F,Faciszewski T,Jensen R.Quality of life following vertebroplasty. J Bone Joint Surg Am. 2004;86-A(12): 2600-2606.
[23]Lo YP,Chen WJ,Chen LH,et al.New vertebral fracture after vertebroplasty.J Trauma.2008;65(6):1439-1445.
[24]师晓琴,彭娜,韩保君,等.骨水泥植入综合征研究进展[J].国际骨科学杂志,2009, 30(3):186-188.
[25]Sarkar S,Mandal K,Bhattacharya P.Successful management of massive intraoperative pulmonary fat embolism with percutaneous cardiopulmonary suppor. Indian J Crit Care Med.2008;12(3):136-139.
[26]Kaufmann TJ,Jensen ME,Ford G,et al.Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty.AJNR Am J Neuroradiol.2002;23(4):601-604.
[27]王世英,孔玲,马志明,等.氢化泼尼松联合小剂量麻黄碱在预防骨水泥植入综合征中的应用[J].中国药师, 2011,14(10): 1489-1491.
[28]唐建国,朋立超,黄鲁铨,等.全髋置换术扩髓及骨水泥灌注对血液动力学的影响及其机制[J].临床麻醉学杂志,2002,18(10): 520-522.
[29]Callaghan JJ,Templeton JE,Liu SS,et al.Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report.J Bone Joint Surg Am. 2004; 86-A(4):690-695.
[30]王宏.急性上呼吸道感染应用皮质激素疗效分析[J].中国药师, 2008,11(2):212-213.