Intravenous Sedation in a Patient With Sotos Syndrome and Intellectual Disability: A Case Report

Sotos syndrome is a genetic disorder characterized by distinct facial features, intellectual disability, and overgrowth. In this case, a patient with Sotos syndrome presented with severe intellectual disability, for which general anesthesia was initially considered. However, at the request of the patient's guardian, the treatment was performed under intravenous sedation. Due to the patient's severe intellectual disability and microtia, administering intravenous sedation was anticipated to be challenging. Nevertheless, the dental treatment was successfully and safely completed by employing multiple strategies. These included using risperidone as premedication, applying a local anesthetic cream, securing the peripheral venous route after nitrous oxide inhalation, and monitoring respiratory status with a capnometer to adjust sedation levels. This report aims to demonstrate the successful management of intravenous sedation in a patient with Sotos syndrome, focusing on the strategies employed to address the unique challenges posed by severe intellectual disability, behavioral difficulties, and anatomical considerations. By highlighting these approaches, we aim to contribute to the limited literature on sedation management for patients with complex medical and behavioral needs.