A Child with Osteum Secundum Atrial Septal Defect and Down Syndrome Undergoing Adenotonsillectomy An Anaesthetic Challenge

Dr. Sarika M Shetty; Dr. Malathi CN; Dr. Nalini Kotekar; Dr. Sandhya Bolla

Volume : IV, Issue : VIII, August - 2015

A Child with Osteum Secundum Atrial Septal Defect and Down Syndrome Undergoing Adenotonsillectomy An Anaesthetic Challenge

Dr. Sarika M Shetty, Dr. Malathi Cn, Dr. Nalini Kotekar, Dr. Sandhya Bolla

Abstract :

The presence of congenital heart disease (CHD) in a child undergoing non–cardiac surgery poses a great challenge for the anaesthesiologists. The challenges include the patient�s age, complexity of the cardiac lesion present, coupled with patient�s capacity to compensate for the physiological changes that occur under anaesthesia, urgency of surgery and the presence of other coexisting diseases(1).CHD occurs in about 40% of children with Down syndrome. Anaesthesia in Down syndrome carries a higher risk due to the prevalence of mental retardation, hypothyroidism, cardio–respiratory manifestations, airway abnormalities and postoperative pulmonary complications(2). Inability to secure an airway, congestive heart failure, arrhythmias, hypoxia,hypercarbia and paradoxical embolism are the factors that place childrenat increased risk during anaesthesia for non–cardiac surgery(3, 4). Adequatepost operative analgesia, prevention of hypoxia, hypercarbia, dehydration and hypothermia is vital (3).