Zhou W, Zhang WJ, Zhao GQ, Li K. Bone cement implantation syndrome during hip replacement in a patient with pemphigus and Parkinson’s disease: A case report. World J Clin Cases 2021; 9(14): 3342-3349 [PMID: 34002143 DOI: 10.12998/wjcc.v9.i14.3342]
Corresponding Author of This Article
Kai Li, MD, PhD, Doctor, Department of Anesthesiology, China Japan Union Hospital of Jilin University, No. 126 Xiantai Avenue, Changchun 130021, Jilin Province, China. likai@jlu.edu.cn
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2021; 9(14): 3342-3349 Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3342
Bone cement implantation syndrome during hip replacement in a patient with pemphigus and Parkinson’s disease: A case report
Wei Zhou, Wen-Jing Zhang, Guo-Qing Zhao, Kai Li
Wei Zhou, Department of Anesthesiology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Wen-Jing Zhang, Guo-Qing Zhao, Kai Li, Department of Anesthesiology, China Japan Union Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Zhou W collected the patient’s clinical data and contributed to literature review; Li K reviewed the literature and drafted the manuscript; Zhang WJ contributed to manuscript revision; Zhao GQ made critical revisions related to important intellectual content of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: There is no conflict of interest for all authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Li, MD, PhD, Doctor, Department of Anesthesiology, China Japan Union Hospital of Jilin University, No. 126 Xiantai Avenue, Changchun 130021, Jilin Province, China. likai@jlu.edu.cn
Received: October 4, 2020 Peer-review started: October 4, 2020 First decision: December 30, 2020 Revised: January 22, 2021 Accepted: March 3, 2021 Article in press: March 3, 2021 Published online: May 16, 2021 Processing time: 207 Days and 3.5 Hours
Abstract
BACKGROUND
Bone cement implantation syndrome (BCIS) is characterized by hypotension, arrhythmia, diffuse pulmonary microvascular embolism, shock, cardiac arrest, any combination of these factors, or even death following bone cement implantation.
CASE SUMMARY
An 80-year-old patient with pemphigus and Parkinson’s disease underwent total hip replacement under spinal subarachnoid block and developed acute pulmonary embolism after bone cement implantation. The patient received mask mechanical ventilation with a continuous intravenous infusion of adrenaline (2 μg/mL) at a rate of 30 mL/h. Subsequently, the symptoms of BCIS were markedly alleviated, and the infusion rate of adrenaline was gradually reduced until the infusion was completely stopped 45 min later. The patient was then transferred to the Department of Orthopedics, and anticoagulation therapy began at 12 h postoperatively. No other complications were observed.
CONCLUSION
This is a rare case of BCIS in a high-risk patient with pemphigus and Parkinson’s disease.
Core Tip: Bone cement implantation syndrome (BCIS) is an important cause of death and disability during the perioperative period of total hip replacement. The present patient with pemphigus and Parkinson's disease had a higher risk of BCIS than the general population due to pathophysiological changes and current medications. Therefore, the choice of anesthetic method for such patients must take full account of their current conditions. In addition, vital signs must be closely monitored intraoperatively to prevent the occurrence of BCIS.
