Effect Of Methylprednisolone On Bone Cement Implantation Syndrome During PVP

Objective:With the aging of society,the incidence of osteoporosis is increasing.Pain and osteoporotic fractures seriously affect the health and quality of life of these patients.Osteoporotic fractures refer to fractures that occur under low energy(external forces that do not cause fractures under normal circumstances)and exclude pathological fractures.Therefore,they are also called fragile fractures,mainly occurring in the elderly,especially postmenopausal women.Including spine vertebral compression fractures,femoral neck fractures,distal radius fractures and proximal humerus fractures.Percutaneous Vertebroplasty(PVP),Percutaneous Kyphoplasty(PKP),and hip replacement are now commonly used for the treatment of vertebral compression fractures and femoral neck fractures in elderly patients.Bone cement plays a vital role in these operations.However,bone cement may cause a series of clinical symptoms,including hypotension,arrhythmia,severe hypoxemia,myocardial infarction,increased pulmonary arterial pressure,altered coagulation function,asthma attacks and so on.It is called Bone Cement Implantation Syndrome(BCIS).Therefore,this study aims to explore whether the use of methylprednisolone in PVP surgery can affect the occurrence of BCIS.Methods:According to the inclusion and exclusion criteria,a total of 60 patients(30 in the experimental group and 30 in the control group)were randomly selected from subei people's hospital of jiangsu province for PVP.The general conditions of patients,including hypertension,diabetes,cardiopulmonary and cerebrovascular diseases,andanesthesia ASA grading,were collected.The study and related risks were described to the patients and their families in detail.After obtaining the consent of the patients and their families and signing the informed consent form,60 enrolled patients were randomly divided into the experimental group(n=30)and the control group(n=30)by using a random number table.In the experimental group,1 ml of methylprednisolone(40 mg)was given for 1 minute before bone cement injection.In the control group,1 ml of saline was given for 1 minute before bone cement injection in PVP.Systolic blood pressure,diastolic blood pressure,heart rate,and blood oxygen saturation changes were recorded 1 minute before,1 minute,3 minutes,5 minutes,7 minutes,and 10 minutes after bone cement injection in two groups.SPSS20 was used for statistical analysis of the data,and 2 test was used for the general count data of the patients(such as the number of patients with hypertension,diabetes and other diseases).The value of the measurement data are used to mean standard deviation(s)said.Firstly,intra-group analysis and comparison were conducted in the two groups,and the data of each indicator in the two groups were tested for homogeneity of variance respectively,and then analy Oed by one-way anova or non-parametric test.Then,the changes of each indicator in the control group and the experimental group at the same time point were tested for normality and homogeneity of variances,and then the independent sample t test or non-parametric test were used for comparison between groups.In all tests,when P0.05,the difference was considered to be statistically significant.Result:There was no significant difference between the two groups in gender,age,classification of anesthesia ASA,hypertension,diabetes,cardiopulmonary and cerebrovascular diseases(bradycardia,coronary heart disease,cerebral infarction,COPD,etc.)(P >0.05).The results of intra-group comparative analysis showed that The differences of SBP,DBP and HR in the control group were statistically significant(P 0.05),and the most significant changes were in SBP,DBP and HR at 3-5 minutes after injection.The difference of SBP,DBP and HR in the experimental group was not statistically significant(P > 0.05).Sa O2 in both groups was 100%,and there was no change before and after bone cement implantation.Group between the comparativeanalysis results show that the implanted in bone cement after 1,3,5,7 minutes,the SBP,DBP variation of two groups' differences statistically significant(P 0.05),bone cement implantation after 10 minutes,the SBP,DBP variation of two groups‘difference is not significant difference(P > 0.05),and two groups of HR variation only in bone cement into 3 minute differences statistically significant(P 0.05),the rest of the observation point difference is not significant.Conclusion:1.The use of methylprednisolone in PVP can stabili Oe systolic blood pressure,diastolic blood pressure and heart rate of patients,and reduce the influence of BCIS on patients.2.BCIS had little effect on pulmonary ventilation function during PVP,which may be related to low amount of bone cement,low pressure of bone cement implantation,no pulmonary embolism or less toxic effect of monomer bone cement.