Challenges in syndromic pediatric anesthesia: Case report urachal fistula in infant with Down Syndrome

Abstract

Anesthetic management in infants with Down Síndrome requires a meticulous strategy due to their unique anatomical and physiological characteristics. The main challenges lie in securing the airway and maintaining cardiovascular stability. From an epidemiological perspective, this clinical scenario combines one of the most common chromosomal abnormalities with a rare congenital malformation, which increases the complexity of its management. We present the case of a 6-month-old male infant diagnosed with a urachal fistula, manifested by urine leak age through the umbilical scar and associated omphalitis. He underwent laparoscopic urachal excision using a balanced general anesthetic technique, focusing on four key areas: airway protection and mechanical ventilation, autonomic and hemodynamic stability, pneumoperitoneum management, and analgesia management. Base dont his case, are view was conducted on the most relevant considerations to take into account during anesthetic assessment and management.