A patient with Noonan syndrome may have a number of findings which must be taken into account during anesthesia and surgery.



difficult airway

preoperative assessment to identify problems prior to establishing an airway

congenital heart disease

cardiac monitoring and ventilatory support


steps to control bleeding, especially in the postoperative period

orthopedic malformations

positioning and padding to minimize pressure points

intellectual impairment

procedural restraints, lack of cooperation


The difficult airway may be a result of:

(1) limited mouth opening

(2) cervical spine anomalies

(3) craniofacial anomalies and deformities


Congenital heart disease may involve:

(1) pulmonary valve stenosis

(2) hypertrophic obstructive cardiomyopathy

(3) ventricular septal defect (VSD)

(4) patent ductus arteriosus

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