Perioperative Challenges in Mentally Handicapped Patients

Abstract

Survival of mentally handicapped patients (MHP) from infancy into adulthood has significantly improved, and so have methods to assist them in their daily life. However, developments in perioperative care or in dentistry have generally not met many special challenges that surface when a mentally handicapped patient needs operative treatment. The revealing comparison with the pediatric patients shows that mentally handicapped patients do not receive special attention attuned to their needs, like children do. While normal children may be approached as a group of similar individuals this does not work for the handicapped for they are all different with a myriad of special needs. These needs are disadvantageous and complicating in the perioperative period. Vital needs are not always easy to identify, and may be difficult to meet when one follows a routine perioperative approach. Mental shortcomings and associated handicaps may be a credit for after life, but are no blessing on earth, neither for the sufferer nor for the care provider. MHP requiring anesthetic care present problems to the anesthetist that are challenging and may defeat the unprepared [1]. Psychiatric patients form a separate category of surgical population and are not considered in this perioperative context of MHP.