Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
LetterLetter

Cardiovascular Effects of Polymethylmethacrylate or Cardiovascular Effects of Conscious Sedation?

Gabriele Levrini, Maurizio Zompatori, Gianni De Berti and Franco Nicoli
American Journal of Neuroradiology November 2006, 27 (10) 2022;
Gabriele Levrini
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maurizio Zompatori
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gianni De Berti
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Franco Nicoli
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
Loading

We read with interest the article by Kaufmann et al1 about the cardiovascular effects of polymethylmethacrylate (PMMA) injection during percutaneous vertebroplasty (PV).

The authors compared patients’ vital signs before with those during and after PMMA injection: no significant differences were noted between preinjection mean arterial pressure (MAP) and that during, 5 minutes after, and 10 minutes after PMMA injection. The authors concluded that there were no clinically relevant generalized systemic cardiovascular effects related to PMMA injection during PV.

We retrospectively reviewed charts of 33 consecutive patients who underwent 48 PVs at our institution: systolic and diastolic blood pressure, heart rate (HR), and systemic arterial oxygen saturation were recorded from before, during, 10 minutes after, and 20 minutes after PMMA injection. Conscious sedation was administered by an experienced interventionalist (G.D.B.) and titrated for effect.

Our results differ substantially from those reported by Kaufmann and colleagues: a significant difference was noted between preinjection MAP and MAP during, 10 minutes after, and 20 minutes after PMMA injection using the paired Student t test (P = .04, 0.03, 0.02). On the other hand, no significant differences were noted between MAP during PMMA injection and MAP 10 and 20 minutes after PMMA injection.

We hypothesize a role for the routinely administered sedatives and narcotics (meperidine and midazolam), whose effects (in particular for meperidine) are widely known: meperidine anesthesia results in a moderate reduction in blood pressure and a marked depression in cardiac output.

Reply:

We appreciate the contribution of the authors, who found significant differences in mean arterial pressure (MAP) before polymethyl- methacrylate (PMMA) injection during percutaneous vertebroplasty (PVP) compared with that during and after injection, in contradistinction to our previously published results.1 We absolutely concur that moderate sedation has the potential for creating alterations in vital signs, including MAP. We would expect that particularly with varying practices of moderate sedation, the potential exists for discovering statistically significant variations in vital signs during PVP. For any such discovered vital sign perturbations, we would consider it very difficult to identify the relative contributions to the perturbations from factors such as prone positioning of patients, moderate sedation, and direct effects of PMMA on the cardiovascular system. If other investigators find statistically significant alterations in vital signs during PVP, it would also be important to know the effect size of these alterations (ie, whether statistically significant alterations in vital signs are also clinically significant). In our clinical practice before and since our 2002 report, we have not found vital sign alterations during PVP to be a significant clinical issue, beyond what it is for any other procedure involving moderate sedation.

Reference

  1. ↵
    Kaufmann TJ, Jensen ME, Ford G, Gill LL, Marx WF, Kallmes DF. Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty. AJNR Am J Neuroradiol 2002;23:601–04
    Abstract/FREE Full Text
  • Copyright © American Society of Neuroradiology
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 27 (10)
American Journal of Neuroradiology
Vol. 27, Issue 10
November 2006
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Cardiovascular Effects of Polymethylmethacrylate or Cardiovascular Effects of Conscious Sedation?
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Cardiovascular Effects of Polymethylmethacrylate or Cardiovascular Effects of Conscious Sedation?
Gabriele Levrini, Maurizio Zompatori, Gianni De Berti, Franco Nicoli
American Journal of Neuroradiology Nov 2006, 27 (10) 2022;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Cardiovascular Effects of Polymethylmethacrylate or Cardiovascular Effects of Conscious Sedation?
Gabriele Levrini, Maurizio Zompatori, Gianni De Berti, Franco Nicoli
American Journal of Neuroradiology Nov 2006, 27 (10) 2022;
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Reference
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Axonal loss is progressive and partly dissociated from lesion load in early multiple sclerosis
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Reply
  • 2018–2022 Radiology Residency and Neuroradiology Fellowship Match Data: Preferences and Success Rates of Applicants
  • The Nosologic Term “Conversive” Disorder Should Be Abandoned
Show more Letters

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2021 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2022 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire