Anaesthesia and Down Syndrome

Overview

 

People with Down syndrome  are more likely to require an anaesthetic as part of the management of many of the medical conditions associated with the syndrome e.g. congenital heart problems, gastrointestinal anomalies,orthopaedic, ophthalmic and ENT problems.

Approaches to anaesthetic procedures, and post operative management can be more complex because of the intellectual disability , or dual diagnosis of Autism spectrum disorder.

Certain specific features of the syndrome should be taken into account and younger children or those with complex difficulties , especially related to airway or cardiac conditions may need to be managed in specialist centres.

  • General hypotonia.
  • Risk of atlanto-axial instability (AAI). Screening questions pre-anaesthesia more helpful than X-Rays
  • Narrow airways, and tendency to obstructive breathing
  • Associated congenital heart conditions
  • Obesity
  • Co-existing diabetes
  • Co-existing epilepsy

All anaesthetic and surgical teams should be aware of the special features of those  with Down syndrome and have protocols for their management.

 

 

Presentations at DSMIG Meetings

Still to be uploaded

Anaesthetic issues for children with Down’s syndrome

DSMIG meeting November 2014 RSM London

Dr Liam Brennan consultant Paediatric Anaesthetist Cambridge University Hospitals NHS Trust.