• Chian-Lang Hong, Hung-Pin Liu, Chung-Yuan Wu, Angie C Y Ho, Ming-Hwang Shyr, Chung-Hang Wong, and Han See Chun.
• Department of Anesthesia, Chang Gung Memorial Hospital at Chia Yi, No. 6, Sec West, Chia Pu Road, Putz City, Chia Yi, Taiwan, R.O.C.
• Acta Anaesthesiol. Sin. 2003 Mar 1; 41 (1): 47-51.

AbstractWe report a case of delayed hypoxemia in an aged healthy male patient, which developed 2 hours after cementation of the prosthesis in total hip replacement (THR) under spinal anesthesia. The patient was doing well throughout the operation but unfortunately, progressive tachypnea was noted 1 h after he was transferred to the recovery room (i.e. 2 h after the application of bone cement into the femur). An hour further, distinct wheeze was heard bilaterally on auscultation, which signified bronchospasm. Arterial blood gases analysis revealed a low PaO2 of 71 mmHg and a decrease of oxygen saturation to 91% with supplement of fractional oxygen of 35%. Aerosolization of bronchodilator with terbutaline was administered and supplemental fractional oxygen was increased to 50%. Although wheezing soon subsided, tachypnea and desaturation persisted. He was then transferred to the surgical intensive care unit for further management. Ventilation-perfusion lung scan was performed, which was suggestive of multiple pulmonary embolism.

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