Methylmethacrylate bone cement does not release histamine in patients undergoing prosthetic replacement of the femoral head

This study was designed to see if methyl methacrylate monomerbone cement released his tamine in 13 patients undergoing totalhip replacement surgery with a cemented prosthesis, comparedwith seven control patients receiving a cementless porous-coatedprosthesis. Blood samples for plasma concentrations of histaminewere obtained before the start of anaesthesia, immediately beforeinsertion of methylmethacrylate bone cement into the shaft ofthe femur in the cemented fixation group or before insertionof the femoral component of the prosthesis in the cementlessfixation group, and 15, 30 and 60 min after the start of implantationof the prosthesis. In both groups, changes in plasma histaminedid not differ significantly from baseline before implantationof cement. There were no significant differences between groups.We conclude that methyl-methacrylate bone cement does not releasehis tamine during total hip replacement surgery.     

Convulsions associated with epidural analgesia during sevoflurane anaesthesia

A three-year-old girl who underwent an operation for adrenal neuroblastoma was anaesthetized with sevoflurane and epidural analgesia. In the immediate recovery period she had convulsions. The convulsions were successfully treated with thiopentone and sevoflurane, there were no neurological sequelae. The convulsions were considered to be a manifestation of mepivacaine toxicity because of a high plasma mepivacaine concentration. Complications of paediatric regional analgesia and manifestations of mepivacaine toxicity under sevoflurane anaesthesia are discussed.