Section Heading Background Image


For people with Down syndrome, family members, caregivers and professionals.


June 2011 | Brian Chicoine, MD - Medical Director, Adult Down Syndrome Center

Is there anything special about undergoing anesthesia for people with Down syndrome? 

A few things to consider with anesthesia for people with Down syndrome are: 

  • The higher incidence of cervical subluxation (especially atlanto-axial instability). The “looseness” of the bones in the neck in some people with Down syndrome, with one vertebrae slipping over another, can put the person at risk for the spinal cord getting pinched. This can be an issue in the operating room when under general anesthesia. When the person’s neck is moved to intubate (put the breathing tube in), this can cause the spinal cord to get pinched in a person with this problem. The anesthesiologist can avoid the problem by using a scope to visualize the airway rather than bending the neck back like is usually done to intubate. 
  • Gastroesophageal reflux. People with DS have a higher incidence of the contents of the stomach “going backwards” up into the esophagus. This can reflux all the way up the esophagus (especially when lying flat) and enter the airway. This can be a dangerous situation in the operating room. The anesthesiologist can be particularly cautious with the airway to prevent this problem.
  • Higher incidence of swallowing problems. Along with the issues related to gastroesophageal reflux, people with DS have more swallowing problems and this can lead to saliva “going down the wrong pipe” and into the lungs. 

Want to learn more about anesthesia? See a piece published by the National Institutes of Health:

Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.