A patient with the cri du chat syndrome (partial deletion of the 5p chromosome) may have a number of findings that can affect anesthetic management. Most patients can be managed safely without complications if suitable adjustments are made. the authors are from the University of Hirosaki in Japan.


Potential Risk Factor


anomalies of the upper airway

difficult intubation

generalized muscular hypotonia

unpredictable effects of muscle relaxants

congenital heart disease

cyanosis, require monitoring

feeding difficulties

recurrent aspiration with chronic pneumonia; protection of airway

mental retardation

limited ability to follow commands


Anomalies of the airway affecting intubation:

(1) laryngeal: (a) small, (b) narrow and diamond shaped, (c) laryngomalacia, (d) vocal cord paralysis

(2) epiglottis: (a) hypotonic, (b) hypoplastic, (c) small and flaccid <?= mixed hypotonia and hypoplasia>, (d) long, curved and floppy

(3) retrognathia

(4) high palatal vault


Intubation should be done by a person with experience who has assistance and the proper equipment readily available.


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