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Frequency of anesthesia-related complications in children with Down syndrome under general anesthesia for noncardiac

Lawrence M Borland1, Jacqueline Colligan, Barbara W Brandom

  • 1Department of Pediatric Anesthesiology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. blckrose@pitt.edu

Paediatric Anaesthesia
|August 28, 2004
PubMed

Insights

Patients with Down syndrome (DS) face higher risks for anesthesia complications like bradycardia and airway obstruction during noncardiac surgery. This study quantifies these anesthesia-related complications in DS patients.

Area of Science:

  • Anesthesiology
  • Genetics
  • Pediatrics

Background:

  • Down syndrome (DS), characterized by trisomy 21, presents craniofacial and cardiac anomalies.
  • These anomalies suggest a potential increased risk for anesthesia-related complications (ARCs).
  • Previous studies lacked comprehensive data to quantify this risk in DS patients.

Purpose of the Study:

  • To quantify the incidence and types of anesthesia-related complications in patients with Down syndrome undergoing noncardiac procedures.
  • To compare the risk of ARCs in DS patients to the general surgical population.

Main Methods:

  • Retrospective chart review of patients with DS undergoing anesthesia from 1988 to 1995.
  • Analysis of the Anesthesiology Department Quality Assurance (QA) database for concurrent anesthesia information.
  • Inclusion of 930 anesthetic encounters in 488 DS patients for noncardiac procedures.

Main Results:

  • The most frequent ARCs identified were severe bradycardia (3.66%), natural airway obstruction (1.83%), and postintubation croup (1.83%).
  • Difficult intubation (0.54%) and bronchospasm (0.43%) were also noted.
  • Incidences of bradycardia, airway obstruction, and croup were significantly higher in the DS noncardiac group.

Conclusions:

  • Significant increases in bradycardia, airway obstruction, and postintubation croup were observed in DS patients undergoing noncardiac anesthesia.
  • Further comprehensive reporting and quantitative QA data are essential.
  • Comparison of anesthesia techniques and agents is necessary to ensure patient safety in DS individuals.
Abstract

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