Is there anything special about undergoing anesthesia for
people with Down syndrome?
A few things to consider with anesthesia for people withDown 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 undergeneral anesthesia. When the person's neck is
moved to intubate (put the breathing tube in), this cancause the spinal cord to get pinched in a person with this problem.
The anesthesiologist can avoid the problem by using a scopeto 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 bookhttp://www.woodbinehouse.com/main.asp_Q_product_id_E_978-1-890627-89-8
Want to learn more about anesthesia? See a piece published by the National
Institutes of Health: