The Successful Anesthetic Management of an Adult With Cri-du-Chat Syndrome by Using Personalized Behavioral Strategies: A Case Report

Cri-du-Chat syndrome (CDCS) is a rare genetic disorder caused by a partial deletion of the short arm of chromosome 5, and it is characterized by craniofacial dysmorphism, severe intellectual disability, and behavioral challenges. Anesthetic management in adults with CDCS is rarely reported, as the literature mostly focuses on pediatric cases. We describe the case of a 34-year-old male with CDCS who was scheduled for periodontal surgery under general anesthesia; he refused all pharmacological premedication and exhibited severe separation anxiety. A caregiver-guided behavioral approach using repetitive familiar phrases enabled a calm transfer to the operating room and successful intravenous access. Anticipating a difficult airway due to micrognathia, macroglossia, and a high Mallampati score (III), nasotracheal intubation was achieved uneventfully. Anesthesia was maintained with sevoflurane and opioid-free analgesia. Recovery was smooth, and same-day discharge was accomplished. This report emphasizes the importance of non-pharmacological preparation, meticulous airway planning, and fast-track anesthetic strategies in adult CDCS patients who cannot tolerate conventional premedication.