[Effect of cement implantation and pressor agents in hip replacement on blood pressure].

ABSTRACT

OBJECTIVE: To discuss the change of blood pressure involved by pressor agents after the implantation of cement in hip replacement. METHODS: A total of 172 cases of femoral neck fracture underwent hip replacement in Department of Orthopedics and Trauma, Peking University People's Hospital between July 2008 and July 2013 were involved in this retrospective study. The blood pressure and usage of pressor agents were recorded before and after bone cement implantation. The data of blood pressure and usage of agents were collected according to anesthesia records. All the cases were divided into four groups by the application of pressor agents Free of using agent group (Free-agent group), agents used before implantation of cement group (Pre-agent group), agents used after implantation of cement group (Post-agent group) and agent used before & after implantation of cement group (Pre and Post-agent group). Further statistic analysis was then performed. RESULTS: Free-agent group's mean systolic blood pressure decreased for (4.0 ± 10.3) mmHg. The decreasing was significant (t=3.660, P=0.000). Free-agent group's mean diastolic blood pressure decreased (1.3 ± 7.5) mmHg. The decreasing was not significant (t=2.286, P=0.149). Pre-agent group's mean systolic blood pressure decreased for (0.5 ± 20.2) mmHg. The decreasing was not significant (t=0.114, P=0.911). Pre-agent group's mean diastolic blood pressure increased (0.7 ± 10.2) mmHg. The increasing was not significant (t=-0.316, P=0.756). Post-agent group's mean systolic blood pressure decreased for (6.9 ± 15.0) mmHg. The decreasing was significant (t=3.195, P=0.002). Post-agent group's mean diastolic blood pressure decreased (3.6 ± 7.4) mmHg. The decreasing was significant (t=3.407,P=0.001). Pre & Post-agent group's mean systolic blood pressure decreased for (5.0 ± 12.2) mmHg. The decreasing was not significant (t=1.667, P=0.115). Pre & Post-agent group's mean diastolic blood pressure increased (1.3 ± 8.5) mmHg. The increasing was not significant (t=-0.656, P=0.521). CONCLUSION: Implantation of cement in hip replacement surgery causes blood pressure decreasing. The application of pressor agents before cement implantation can stabilize blood presure and shorten the period of hypotension.