TABLE IV.

Intraoperative Steps to Avoid Bone Cement Implantation Syndrome

Notify anesthesia team of the plan to use cement and again at time of cementation

Use invasive monitoringjudiciously in at-risk patients

Communicate with anesthesia team regarding blood loss, volume status, and blood pressure

Ensure adequate volume maintenance before and during cementation

Prepare for use of vasopressors

Avoid cementation in patients already on vasopressors

Thoroughly irrigate the femoral canal before instrumentation

Place cement later in curing phase (minimizes monomer exposure)

Avoid overpressurizing of the cement in susceptible patients