Airway and respiratory management for anesthesia in the patients with severe motor and intellectual disabilities

BACKGROUND: For the management of general anesthesia in the patients with severe motor and intellectual disabilities, airway and respiratory disorders are severe and may cause fatal events. We retrospectively examined these risk factors. METHODS: We assessed adverse airway and respiratory events associated with anesthesia from perioperative and anesthetic records of these patients retrospectively. RESULTS: Forty-one cases (31 were for fundoplication, and 10 were for gastrostomy or jejunostomy) were involved. On anesthetic introduction, in 9 cases tracheal intubation was difficult (failed in 1 case). These and other 4 cases had developed pharyngeal and laryngeal edema. Manual ventilation by facemask was successful in all cases. During the postoperative period, pneumonia (5 cases), pleural effusion (1 case), and apnea (2 cases) occurred unexpectedly. CONCLUSIONS: Patients with severe motor and intellectual disabilities belong to the group with high risk for general anesthesia.