Anaesthetic management of hip arthroplasty in an individual with trisomy 21 and Eisenmenger's syndrome

A 49-year-old man with trisomy 21 and Eisenmenger's syndrome presented for hip arthroplasty. Eisenmenger's syndrome is defined by the presence of obstructive pulmonary vascular disease secondary to long-standing left-to-right shunt causing pulmonary hypertension, eventually leading to shun...

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Bibliographic Details
Published in:BMJ case reports 2013-04, Vol.2013, p.bcr2012008154
Main Authors: Bilak, Joanna M, Saddler, John
Format: Article
Language:English
Subjects:
Anesthesia, General - methods
Arthroplasty, Replacement, Hip
Blood pressure
Congenital diseases
Down Syndrome - complications
Eisenmenger Complex - complications
Humans
Joint surgery
Male
Middle Aged
Nerve Block
Rare Disease
United Kingdom
White
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Summary:A 49-year-old man with trisomy 21 and Eisenmenger's syndrome presented for hip arthroplasty. Eisenmenger's syndrome is defined by the presence of obstructive pulmonary vascular disease secondary to long-standing left-to-right shunt causing pulmonary hypertension, eventually leading to shunt reversal in to right-to-left direction. Patients with Eisenmenger's syndrome pose a significant perioperative risk because of the physiological alterations induced by anaesthetic agents. The choice of anaesthetic technique in these patients is therefore not straightforward. A successful outcome was achieved with general anaesthesia supplemented with nerve blocks.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-008154