Anesthesia considerations in children with Down syndrome

The anomalies associated with Down syndrome present some interesting challenges for the anesthesiologist. Airway difficulties, a potentially unstable cervical spine, and a high incidence of congenital heart disease all require careful consideration. Impaired immune function predisposes to chronic infections and demands attention to asepsis during invasive procedures. Finally, there is the very considerable challenge of providing kind and considerate anesthesia care and effective postoperative pain management for a cognitively impaired child.