Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1988 Jan;81(1):23–26. doi: 10.1177/014107688808100111

Anaesthetic considerations in facial reconstruction for Down's syndrome.

B Beilin 1, A Kadari 1, Y Shapira 1, D Shulman 1, J T Davidson 1
PMCID: PMC1291423  PMID: 2963914

Abstract

Sixty-three patients with Down's syndrome underwent facial reconstructive surgery under general anaesthesia in order to improve their acceptability and potential for functioning effectively in society. Preoperatively, one-third of the patients had respiratory illnesses, 11 (17.5%) had cardiac anomalies, and 5 (7.9%) had endocrinological abnormalities. Anaesthesia was based on spontaneous ventilation of halothane and N2O in oxygen via an endotracheal tube with appropriate monitoring. Only one patient had an intraoperative complication, an episode of ventricular dysrhythmia, but postoperatively 9 patients required nasopharyngeal airways or endotracheal intubation in order to maintain a patent upper airway. The anaesthetic considerations for facial reconstructive surgery in Down's syndrome are discussed.

Full text

PDF
23

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chi TPL?Krovetz J. The pulmonary vascular bed in children with Down syndrome. J Pediatr. 1975 Apr;86(4):533–538. doi: 10.1016/s0022-3476(75)80142-9. [DOI] [PubMed] [Google Scholar]
  2. Clark R. W., Schmidt H. S., Schuller D. E. Sleep-induced ventilatory dysfunction in Down's syndrome. Arch Intern Med. 1980 Jan;140(1):45–50. [PubMed] [Google Scholar]
  3. Coleman M., Abbassi V. Down's syndrome and hypothyroidism: coincidence or consequence? Lancet. 1984 Mar 10;1(8376):569–569. doi: 10.1016/s0140-6736(84)90972-3. [DOI] [PubMed] [Google Scholar]
  4. Cooney T. P., Thurlbeck W. M. Pulmonary hypoplasia in Down's syndrome. N Engl J Med. 1982 Nov 4;307(19):1170–1173. doi: 10.1056/NEJM198211043071902. [DOI] [PubMed] [Google Scholar]
  5. Grobovschek M., Strohecker J. Congenital atlanto-axial subluxation in Down's syndrome. Neuroradiology. 1985;27(2):186–186. doi: 10.1007/BF00343797. [DOI] [PubMed] [Google Scholar]
  6. Harris W. S., Goodman R. M. Hyper-reactivity to atropine in Down's syndrome. N Engl J Med. 1968 Aug 22;279(8):407–410. doi: 10.1056/NEJM196808222790805. [DOI] [PubMed] [Google Scholar]
  7. Keele D. K., Richards C., Brown J., Marshall J. Catecholamine metabolism in Down's syndrome. Am J Ment Defic. 1969 Jul;74(1):125–129. [PubMed] [Google Scholar]
  8. Kobel M., Creighton R. E., Steward D. J. Anaesthetic considerations in Down's syndrome: experience with 100 patients and a review of the literature. Can Anaesth Soc J. 1982 Nov;29(6):593–599. doi: 10.1007/BF03007747. [DOI] [PubMed] [Google Scholar]
  9. Lemperle G., Radu D. Facial plastic surgery in children with Down's syndrome. Plast Reconstr Surg. 1980 Sep;66(3):337–345. [PubMed] [Google Scholar]
  10. Morray J. P., Mac Gillivray R., Duker G. Increased perioperative risk following repair of congenital heart disease in Down's syndrome. Anesthesiology. 1986 Aug;65(2):221–224. doi: 10.1097/00000542-198608000-00020. [DOI] [PubMed] [Google Scholar]
  11. Olbrisch R. R. Plastic surgical management of children with Down's syndrome: indications and results. Br J Plast Surg. 1982 Apr;35(2):195–200. doi: 10.1016/0007-1226(82)90163-1. [DOI] [PubMed] [Google Scholar]
  12. ROWE R. D., UCHIDA I. A. Cardiac malformation in mongolism: a prospective study of 184 mongoloid children. Am J Med. 1961 Nov;31:726–735. doi: 10.1016/0002-9343(61)90157-7. [DOI] [PubMed] [Google Scholar]
  13. Semine A. A., Ertel A. N., Goldberg M. J., Bull M. J. Cervical-spine instability in children with Down syndrome (trisomy 21). J Bone Joint Surg Am. 1978 Jul;60(5):649–652. [PubMed] [Google Scholar]
  14. Steward D. J. Congenital abnormalities as a possible factor in the aetiology of post-intubation subglottic stenosis. Can Anaesth Soc J. 1970 Jul;17(4):388–390. doi: 10.1007/BF03004702. [DOI] [PubMed] [Google Scholar]
  15. Strome M. Down's syndrome: a modern otorhinolaryngological perspective. Laryngoscope. 1981 Oct;91(10):1581–1594. doi: 10.1288/00005537-198110000-00001. [DOI] [PubMed] [Google Scholar]
  16. Weesner K. M., Rosenthal A. Gastroesophageal reflux in association with congenital heart disease. Clin Pediatr (Phila) 1983 Jun;22(6):424–426. doi: 10.1177/000992288302200606. [DOI] [PubMed] [Google Scholar]
  17. Wexler M. R., Pled I. J., Shapiro J., Tiecher S., Sela M., Kadari A., Mintzker Y., Feuerstein R. [Facial plastic surgery in Down's syndrome]. Harefuah. 1984 May 15;106(10):439–443. [PubMed] [Google Scholar]
  18. Wilson S. K., Hutchins G. M., Neill C. A. Hypertensive pulmonary vascular disease in Down syndrome. J Pediatr. 1979 Nov;95(5 Pt 1):722–726. doi: 10.1016/s0022-3476(79)80718-0. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES