Kuroda Izumi, Fujita Arisa, Okumura Yoko, Tachi Naoko, Sato-Boku Aiji
Department of Anesthesiology, Aichi Gakuin University, Nagoya, JPN.
Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, JPN.
Cureus. 2024 Dec 29;16(12):e76555. doi: 10.7759/cureus.76555. eCollection 2024 Dec.
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.
索托斯综合征是一种遗传性疾病，其特征为独特的面部特征、智力残疾和生长过度。在本病例中，一名患有索托斯综合征的患者存在严重智力残疾，最初考虑进行全身麻醉。然而，应患者监护人的要求，治疗在静脉镇静下进行。鉴于患者存在严重智力残疾和小耳畸形，预计实施静脉镇静具有挑战性。尽管如此，通过采用多种策略，牙科治疗得以成功且安全地完成。这些策略包括使用利培酮作为术前用药、涂抹局部麻醉乳膏、在吸入氧化亚氮后确保外周静脉通路，以及使用二氧化碳监测仪监测呼吸状态以调整镇静水平。本报告旨在展示对一名索托斯综合征患者静脉镇静的成功管理，重点关注为应对严重智力残疾、行为困难和解剖学因素所带来的独特挑战而采用的策略。通过强调这些方法，我们旨在为关于有复杂医疗和行为需求患者镇静管理的有限文献做出贡献。
