Anesthesia Management of Patients with Mental Retardation

Abstract

Mental retardation is a condition likely to develop secondarily to several genetic diseases or to some negative conditions and diseases that occur before, during or after birth. Anaesthetic practices start with the preoperative visit of a patient and are then followed by premedication, preoperative preparation, intraoperative procedures and postoperative periods. All these steps with mentally retarded patients involve separate characteristics. The MR patients must be kept under observation in the recovery rooms for longer periods of time and must also be definitely re-evaluated by an experienced anaesthetist before being transferred to the service department. Since there may be several challenges/difficulties likely to be experienced at each stage of the mentally retarded patients’ anaesthesia, far more care and patience is required. A pre-anaesthetic evaluation involving a physical examination in depth and a detailed questioning should be performed. During the pre-medication period, a little amount of midazolam mixed with a proper drink can be used. Prior to applying the neuromuscle blocking agents, the airway opening must be maintained. In the presence of muscular dystrophies, the doses of neuromuscular blocking agents must be equalized. The MR patients must be kept under observation in the recovery rooms for longer periods of time and must also be definitely re-evaluated by an experienced anaesthetist before being transferred to the service department.