Abstract | BACKGROUND:
Osteogenesis imperfecta is the collective term for a heterogeneous group of connective tissue syndromes characterized by bone fragility with multisystem involvement and perioperative implications. AIMS: Literature review of anesthetic management of patients with osteogenesis imperfecta revealed a paucity of data on the incidence of perioperative challenges. We sought to determine the rates of these challenges in our study cohort. METHODS: Data were collected in a specialty orthopedic hospital from 2008 to 2015 for 83 osteogenesis imperfecta patients undergoing 205 surgeries: 203 orthopedic surgeries and 2 mid-face reconstructive surgeries. Airway management, intravenous access, surgical blood loss, use of peripheral nerve blockade and/or neuraxial techniques, presence of perioperative fracture, and peak intraoperative temperature were evaluated and analyzed. RESULTS: Difficult airway was encountered in 3/205 (1.5%) cases and perioperative fracture in 2/205 (1%) cases. Neuraxial anesthesia was attempted in 64/205 cases with an 87.5% success rate. All peripheral nerve block attempts (33/205 cases) were successful. Difficult intravenous catheter placement was noted in 8/205 (4%) cases. Estimated blood loss >10% of estimated blood volume was considered significant, and occurred in 35/205 (17%) cases. Significant blood loss occurred more often in severe osteogenesis imperfecta types: 18/76 (23.7%) in Type III and 11/65 (16.9%) in Type IV, whereas only 4/47 (8.5%) occurred in mild Type I. In our 205 case cohort, osteogenesis imperfecta Type III had 5.6 times the odds [(95% CI = 1.8-17.2) P = 0.003] of having an anesthetic complication as compared to osteogenesis imperfecta Type I. CONCLUSION:
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Authors | Leelach Rothschild, Jessica K Goeller, Polina Voronov, Alexandra Barabanova, Peter Smith |
Journal | Paediatric anaesthesia
(Paediatr Anaesth)
Vol. 28
Issue 11
Pg. 1050-1058
(11 2018)
ISSN: 1460-9592 [Electronic] France |
PMID | 30295359
(Publication Type: Journal Article)
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Copyright | © 2018 John Wiley & Sons Ltd. |
Chemical References |
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Topics |
- Adolescent
- Adult
- Anesthesia
(methods)
- Anesthetics
(administration & dosage)
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Orthopedic Procedures
- Osteogenesis Imperfecta
(physiopathology, surgery)
- Perioperative Period
- Retrospective Studies
- Young Adult
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