title: Anaesthetic management of hip arthroplasty in an individual with trisomy 21 and Eisenmenger's syndrome.
abstract: 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.
authors.affiliation: Peninsula Medical School, Exeter, UK.
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Bilak
authors.forename: John
authors.initials: J
authors.lastname: Saddler
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip; D004314:Down Syndrome / Q000150:complications*; D004541:Eisenmenger Complex / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block