Down's syndrome and anaesthesia

Abstract

Down's syndrome is a common congenital abnormality associated with characteristic morphological features, impaired intellectual development and disorders of many organ systems with a broad spectrum of severity. Many of these, including defects in cosmetic appearance, are amenable to surgical correction. The risks of anaesthesia are increased in these children. In this article the anaesthetic implications of the syndrome are reviewed and the principles of perioperative management discussed.

Down syndrome: Common otolaryngologic manifestations

“…Approximately 15% of patients with DS have AAI [Pueschel and Scola, 1987]. Individuals with instability of the cervical spine are thought to be at risk for developing subluxation in the face of head and neck trauma [Litman et al, 1995;Mitchell et al, 1995]. One of the difficulties surrounding AAI is that the majority of individuals with this type of instability are totally asymptomatic.…”

Current dilemmas in Down syndrome clinical care: Celiac disease, thyroid disorders, and atlanto‐axial instability

“…There is a theoretical risk of athletic injury, and a greater risk from neck manipulation during surgical procedures (usually related to anesthesia) [Cremers et al, 1993;Mitchell et al, 1995]. Clinicians who perform common procedures that put children with DS at risk (anesthesia, neck manipulation in surgery, especially ear, nose, and throat procedures) should treat all children with DS as if they are vulnerable (universal precautions).…”

Health Supervision for Children With Down Syndrome

“…22 • Discuss with parents the importance of cervical spine-positioning precautions to avoid excessive extension or flexion to protect the cervical spine during any anesthetic, surgical, or radiographic procedure. 23,24 • Discuss efficacy of early intervention and availability of earlyintervention services and therapies in the community. Initiate referral as appropriate.…”