[Intraoperative complications during cementation of hip arthroplasty. Avoiding air embolization during cementation]

Circulatory collapse is known to occur during cementation of hip arthroplasty. The pathogenesis is multifarious, but the most important cause is believed to be formation of air embolism during insertion and cementation of the femoral component followed by air embolism in the heart. Inserting the cement retrogradely with a cement gun following distal plugging of the femoral cavity with spongiosa and using a plastic catheter for suction drainage reduces the air embolisation. Cement producing as little heat as possible during the setting should be used. Maintaining anaesthesia with N2O air embolism and should be avoided during and after cementation. Pre- and intraoperative care of the patient's circulation and oxygenation is essential. The use of pulse oximetry, capnography and precordially recorded Doppler ultrasound are recommended for monitoring air embolism.