Key result
Application of high viscosity gentamycin bone cement during bipolar hemiarthroplasty resulted in severe hypotension, bradycardia, hypoxia, and cardiac arrest, with full recovery after resuscitation.
Case Report (n=1)
Highlights the risk of life-threatening Bone Cement Implantation Syndrome during hemiarthroplasty and the importance of prompt recognition and resuscitation.
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Warrants vigilance for BCIS in hemiarthroplasty; hypothesis-generating for high-viscosity gentamicin cement role.
A 51 year old male was admitted in our hospital with fracture neck of right femur and posted for bipolar hemiarthroplasty.Spinal anaesthesia was given in L 2 L 3 space using 3.5ml 0.5% bupivacaine heavy with 25mcg fentanyl, with 25G quincke needle.During application of the high viscosity gentamycin bone cement, patient developed severe hypotension, bradycardia, hypoxia and cardiac arrest.High quality CPR started immediately, patient intubated and intravenous adrenaline 1mg given.After successful resuscitation surgery continued under general anaesthesia.Patient was post operatively ventilated and monitored in surgical ICU for next 6 hours and he made a full recovery.
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Anish. K.A (2013) conducted a case report in Bone Cement Implantation Syndrome (n=1). High viscosity gentamycin bone cement was evaluated on Severe hypotension, bradycardia, hypoxia and cardiac arrest. Application of high viscosity gentamycin bone cement during bipolar hemiarthroplasty resulted in severe hypotension, bradycardia, hypoxia, and cardiac arrest, with full recovery after resuscitation.
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