June 4, 2011 at 11:45am

Is there anything special about undergoing anesthesia for


people with Down syndrome?





A few things to consider with anesthesia for people with

Down syndrome are:



■   the higher incidence of cervical subluxation (especially

atlanto-axial instability).   The "looseness" of the bones in the neck in some

people with  Down syndrome, with one vertebrae slipping over another, can

put the person at  risk for the spinal cord getting pinched.


This can be an issue in the operating room when under

general anesthesia.  When the person's neck is


moved to intubate (put the breathing tube in), this can

cause the spinal cord to get pinched in a person with this problem.


The anesthesiologist can avoid the problem by using a scope

to visual the airway rather than bending the neck back like is usually 

done to intubate.


■  gastroesophageal reflux- people with DS have a higher incidence of the contents of the stomach "going

backwards" up into the esophagus.  This can reflux all the way up the esophagus (especially when lying flat) and

enter the airway.  This can be a dangerous situation in the operating room.  The

anesthiologist can be particularly cautious with the airway to prevent this



■  Higher incidence of swallowing problems—along with the issues related to gastroesophageal reflux, people

with DS have more swallowing problems and this can lead to saliva “going down

the wrong pipe” and into the lungs.


■ These and other issues are addressed in our   Guide to Good Health book



Want to learn more about anesthesia?   See a piece published by the National


Institutes of Health: