Anesthetic considerations for patients with Down syndrome

Patients with Down syndrome, or trisomy 21, present a unique set of anesthetic considerations to anesthesia providers. Down syndrome is the most prevalent genetic disorder worldwide and affects more than 1 in 800 live births. Patients with Down syndrome are afflicted with multiple congenital anomalies that affect almost all of their organ systems. Skillful management during the perioperative period is essential for a good outcome for patients with multiple congenital abnormalities in the cardiopulmonary and musculoskeletal systems. The purpose of this review is to describe clinically significant findings that are common to patients with Down syndrome. In addition to the presentation of clinical anomalies associated with trisomy 21, specific anesthetic considerations and interventions are reviewed.