Author: Mavridou P, et al.
Cureus 17(9): e91969, September 10, 2025. doi:10.7759/cureus.91969
This case report describes the anesthetic management of a 34-year-old man with Cri-du-Chat syndrome (CDCS) undergoing periodontal surgery under general anesthesia. The patient refused pharmacologic premedication and exhibited severe separation anxiety, making behavioral strategies essential. With caregiver guidance, repetitive familiar phrases and a rhythmic song allowed calm transfer and IV access. Anticipating a difficult airway due to micrognathia, macroglossia, and Mallampati III status, a full difficult airway setup was prepared, though nasotracheal intubation was successfully achieved with Macintosh laryngoscopy. Anesthesia was maintained with sevoflurane and opioid-free analgesia using acetaminophen and local infiltration. Recovery was smooth, and same-day discharge was achieved.
What You Should Know:
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Adults with CDCS present special challenges: craniofacial anomalies, behavioral issues, and refusal of standard premedication.
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Non-pharmacologic, caregiver-guided behavioral strategies can replace sedative premedication effectively.
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Airway preparation must be meticulous given high risk of intubation difficulty.
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Opioid-free anesthesia promotes smoother emergence and facilitates same-day discharge in this patient group.
Thank you to Cureus for allowing us to use this article.