Key result
Single epidural anesthesia was associated with increased odds of grade 1 (OR 1.25; 95% CI 1.13-1.43) and grade 3 (OR 3.55; 95% CI 1.52-7.06) BCIS compared with spinal-epidural anesthesia.
Why the study?
Does single epidural anesthesia increase the risk of bone cement implantation syndrome compared to spinal-epidural anesthesia in aged patients undergoing hemiarthroplasty?
Cohort (n=1,210)
Does single epidural anesthesia increase the risk of bone cement implantation syndrome compared to spinal-epidural anesthesia in aged patients undergoing hemiarthroplasty?
Odds Ratio: 1.25 (95% CI 1.13–1.43)
p-value: p=<0.0001
In aged patients undergoing hemiarthroplasty, single epidural anesthesia is associated with a higher risk of severe bone cement implantation syndrome compared to spinal-epidural anesthesia.
BCIS monitoring under intravertebral anesthesia in elderly hemiarthroplasty remains inconclusive; leaves open need for prospective trials before practice change.
The aim of the study was to assess the effect of commonly used intravertebral anesthesia on bone cement implantation syndrome (BCIS) in aged patients undergoing hemiarthroplasty.The medical records of 1210 aged patients receiving hemiarthroplasty under intravertebral anesthesia were retrospectively reviewed. Anesthesia charts for all patients were reviewed for central venous pressure, mean arterial pressure, arterial oxygen saturation, and heart rate before, during, and after cementation. Each patient was classified into no BCIS (grade 0) or BCIS grade 1, 2, or 3 according to the degree of hypotension, arterial desaturation, or loss of consciousness around cementation. Changes in these grades after cementation were compared according to the ways of intravertebral anesthesia used.Among all included patients, 72.2% (874/1210) showed grade 1 or higher grade of BCIS after cementation. Compared with spinal-epidural anesthesia, single epidural anesthesia showed adjusted odds ratios (95% confidence interval) of 1.25 (1.13-1.43) for grade 1, 1.36 (0.83-2.06) for grade 2, and 3.55 (1.52-7.06) for marked postoperatively grade 3 of BCIS versus grade 0 (Type III P < 0.0001).Single epidural anesthesia was associated with increased odds for elevation of these grades after cementation compared with spinal-epidural anesthesia.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2016) conducted a cohort in Aged patients undergoing hemiarthroplasty (n=1,210). Single epidural anesthesia vs. Spinal-epidural anesthesia was evaluated on Grade 1 bone cement implantation syndrome (BCIS) versus grade 0 (OR 1.25, 95% CI 1.13-1.43, p=<0.0001). Single epidural anesthesia was associated with increased odds of grade 1 (OR 1.25; 95% CI 1.13-1.43) and grade 3 (OR 3.55; 95% CI 1.52-7.06) BCIS compared with spinal-epidural anesthesia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: