[Intraoperative hyperpyrexia in patients with osteogenesis imperfecta]

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Medical Genetics

Background:

• Osteogenesis imperfecta (OI) patients are prone to intraoperative hyperpyrexia, a complication that can increase surgical risks.
• Elevated body temperatures during surgery in OI patients can lead to serious complications.
• Managing body temperature in OI patients undergoing surgery is critical.

Purpose of the Study:

• To evaluate the impact of different anesthesia types on intraoperative and postoperative body temperature in osteogenesis imperfecta patients.
• To compare the effects of balanced anesthesia versus total intravenous anesthesia on body temperature regulation in OI.
• To identify anesthesia strategies that mitigate the risk of hyperpyrexia in OI patients.

Main Methods:

• A retrospective study analyzing body temperature curves (pre-, intra-, and postoperative) in 45 osteogenesis imperfecta patients.
• Group A received balanced anesthesia (Enflurane and Fentanyl).
• Group B received total intravenous anesthesia (TIVA) with Propofol and Alfentanil. Intraindividual studies were conducted on 5 patients.

Main Results:

• Preoperative body temperatures were similar between the two anesthesia groups.
• Patients under balanced anesthesia with Enflurane showed stable or increased intraoperative body core temperatures.
• Patients under TIVA with Propofol and Alfentanil consistently exhibited decreased intraoperative body temperatures.

Conclusions:

• Total intravenous anesthesia (TIVA) appears to be a safer choice for managing body temperature in osteogenesis imperfecta patients during surgery.
• Balanced anesthesia using volatile agents like Enflurane may exacerbate hyperpyrexia in OI patients.
• Anesthesia selection significantly influences intraoperative thermoregulation in osteogenesis imperfecta, with TIVA offering better control.