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Bone cement implantation during total hip arthroplasty (THA) has been associated with venous embolism detected with transoesophageal echoeardiography (TEE). 1.2 Embolism of intramedullary debris is the most consistent factor, as shown in results of animal and human studies. 3-s The consequences of right heart and pulmonary embolization of this material are not fully established. Ereth et al. have shown that the degree of embolization did not correlate with changes in haemodynamic variables nor did it result in persistent ventilation-perfusion mismatching, t This case shows the absence of haemodynamic consequences of a large amount of echogenic material that was embolized into the right heart and partially entrapped in the pulmonary artery, illustrating the forgiving nature of the pulmonary bed.Case report A 76-yr-old, 77-kg, ASA II woman was scheduled for THA. In her past medical history she reported a cholecystectomy and an appendicectomy. She also suffered from systemic hypertension treated with beta-blocking agents.Premedication with atropine sulphate 0.25 mg im was administered one hour before surgery. Anaesthesia was induced with etomidate 20 mg and fentanyl 100 Ixg/v. Muscle relaxation was induced with pancuronium 6 mg and anaesthesia was maintained with halothane in a mixture of 50% 02:50% N20, and intermittent doses of fen-CAN J ANAESTH 1994 / 41:9 / pp 850-3

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