%0 Journal Article %A Evangeline Ko Villa %A Dominic Villa %A Rafael C Bundoc %T Narcotrend-guided intraoperative care of a Trisomy 21 paediatric patient who underwent occipitocervical fusion %D 2020 %R 10.1136/bcr-2019-231276 %J BMJ Case Reports %P e231276 %V 13 %N 2 %X A 9-year-old female with Trisomy 21 with complex craniovertebral instability causing severe cervicomedullary compression underwent occipitocervical fusion. This paper will discuss the anaesthetic management and highlight the use of the Narcotrend monitor not only as a depth of consciousness monitor but more importantly as a tool to detect surgery-induced cerebral hypoperfusion by monitoring the right and left cerebral hemispheres independently and simultaneously. %U https://casereports.bmj.com/content/bmjcr/13/2/e231276.full.pdf