Perioperative course and intraoperative temperatures in patients with osteogenesis imperfecta

Abstract

Concerns persist regarding the association of osteogenesis imperfecta with perioperative complications and intraoperative hyperpyrexia. The purpose of this study is to examine whether osteogenesis imperfecta patients develop intraoperative hyperthermia and to describe anaesthesia-related complications. Medical records of 49 osteogenesis imperfecta patients undergoing 180 anaesthetics were reviewed for the presence of perioperative anaesthetic complications. In a subset of osteogenesis imperfecta non-cardiac surgical patients with available intraoperative temperatures (n = 31), a 2: 1-matched study design was utilised to examine intraoperative temperature and metabolic changes. Temperatures and end-tidal carbon dioxide measurements were analysed using a mixed linear model with temperature as the dependent variable with group (osteogenesis imperfecta vs. control) and time included as explanatory variables. In this cohort of 49 osteogenesis imperfecta patients, there were no perioperative complications associated with anaesthetic care. Intraoperative temperature during non-cardiac surgery was found to increase over time in both osteogenesis imperfecta and control patients (main effect of time, P < 0.001), but no overall difference was observed between the groups (main effect of group, P = 0.589). The changes in temperature did not differ between groups at any measured intervals (time-by-group interaction, P = 0.938). For end-tidal carbon dioxide, no significant differences were detected (main effect of time, P = 0.747; main effect of group, P = 0.545; and time-by-group interaction, P = 0.800). Osteogenesis imperfecta patients undergoing non-cardiac surgery experienced mild intraoperative hyperpyrexia which was not different from those without osteogenesis imperfecta.