Background:Syndromic children can present with many congenital airway abnormalities which are relevant to anaesthesiologists. They may have difficult ventilation (eg. Pierre Robin syndrome), difficult intubation (eg.TMJ Ankylosis) or both(eg. Pierre Robin syndrome). This study evaluated the anaesthetic management of various syndromic children posted for craniofacial surgeries in a tertiary care centre.

Methods:This was a retrospective audit done on all syndromic children posted for craniofacial surgeries in one year from November 2015–16 in NitteMeenakshi Institute of Craniofacial surgery at K S Hegde Hospital. Their preoperative airway assassmentand  perioperative management data were collected from case records and evaluated.

Results: In the study period, 475 maxillofacial cases were operated, out of which 15 were syndromic children with Pierre Robin syndrome (9),Congenital TMJ ankylosis(2), KlippelFeil syndrome(1), Goldenhar syndrome (1), Down’s syndrome(1) and Treacher Collins syndrome(1). Majority of the cases were induced with propofol with spontaneous breathing and most of them were intubated with fibreoptic bronchoscope.

Conclusion: The management strategy of every syndromic child has to be planned based on history, anatomical and functional airway assessed during the pre anaesthetic evaluation. Proper preparation, planning and execution of the same with expertise is essential to manage all these patients.