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Cardiovascular effects of total hip placement in man; With observations on the effects of methyl methacrylate on the isolated rabbit heart
Author(s) -
Wong K. C.,
Martin Wayne E.,
Kennedy William F.,
Akamatsu Toshio J.,
Convery Robert F.,
Shaw Curtis L.
Publication year - 1977
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1977216709
Subject(s) - medicine , anesthesia , bradycardia , heart rate , depression (economics) , atropine , anesthetic , cardiac output , stroke volume , cardiology , hemodynamics , blood pressure , economics , macroeconomics
The cardiovascular effects of total hip placement were evaluated in 10 surgical patients, aged 55 to 82, while receiving fluroxene‐N 2 0‐0 2 anesthesia. The anesthetic regimen caused mild cardiovascular depression. The placement of the acrylic cement into the acetabulum and femoral shaft also induced mild cardiovascular depression, but these changes were not significant at p < 0.05. In one 67‐yr‐old woman, there were significant reductions of cardiac output and stroke volume 2 min after the insertion of acrylic into the femoral shaft, despite careful replacement of intravascular loss and careful anesthetic management. Methylmethacrylate (1 × 10 −6 to 1 × 10 −4 , v/v) was administered to 24 isolated perfused rabbits hearts. These concentrations of methylmethacrylate are of the same order as measurable blood levels in surgical patients. There was a dose‐dependent depression of left ventricular dP/dt correlated with a depression of the spontaneous heart rate. When the bradycardia was prevented by electrically pacing the hearts or the administration of atropine, the depressed dP /dt rose to control levels. Reduction in myocardial temperature and heart rate by means of reduction in perfusate temperature of the isolated hearts reduced the myocardial depressant effect of methylmethacrylate.