Does the use of methylmethacrylate cement in total shoulder replacement induce hemodynamic or pulmonary instability?
STUDY OBJECTIVE: To investigate whether the use of methylmethacrylate cement causes hemodynamic or pulmonary instability during total shoulder replacement surgery. DESIGN: Prospective, nonrandomized study. SETTING: Operating room. PATIENTS: 9 ASA physical status I and II patients. INTERVENTIONS: A 20-gauge radial artery catheter was placed in the wrist opposite the surgical site. Sedation with midazolam was provided, and a pulmonary artery catheter was placed through an 8.5-Fr introducer into the patient’s right internal jugular vein. MEASUREMENTS AND MAIN RESULTS: Before induction of anesthesia, systolic, diastolic, and mean arterial blood pressures; heart rate; central venous pressure; systolic, diastolic, and mean pulmonary artery pressures; pulmonary capillary wedge pressure; and thermodilution cardiac output measurements were obtained. Arterial and mixed venous blood gas samples also were collected and analyzed for calculation of Qs/Qt. These hemodynamic and pulmonary parameters w