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BIS-Guided Total Intravenous Anesthesia for Orchiopexy and Circumcision in a Child with Severe Autism: A Case Report
Selçuk Okur1, Müge Arıkan, Gülşen Temel
1Department of Anesthesiology, Karabük State Hospital, Karabük, Turkey.
Insights
Total intravenous anesthesia guided by the Bispectral Index System offers advantages for autistic children undergoing surgery. This approach ensures hemodynamic stability, promotes early recovery, and enhances safety for pediatric patients with autism.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Autism Spectrum Disorder Management
Background:
- Autistic children often exhibit challenging behaviors in hospital settings due to disruptions in routine.
- Managing anesthesia in pediatric patients with autism requires careful consideration of their unique needs.
Purpose of the Study:
- To describe the anesthetic management of a 10-year-old male with severe autism undergoing orchidopexy and circumcision.
- To evaluate the safety and efficacy of Bispectral Index System-guided Total Intravenous Anesthesia (TIVA) in this patient population.
Main Methods:
- Anesthesia was induced with remifentanil, propofol, and atracurium, maintained with TIVA (propofol and remifentanil).
- Bispectral Index System (BIS) monitoring was used to assess anesthetic depth.
- The patient underwent orchidopexy and circumcision.
Main Results:
- No adverse events occurred during the anesthetic management.
- The patient experienced hemodynamic stability and a smooth recovery.
- Discharge from the hospital occurred on the second postoperative day.
Conclusions:
- Bispectral Index System-guided TIVA demonstrates potential advantages for autistic patients.
- Benefits include hemodynamic stability, early recovery, optimized anesthetic delivery, and enhanced safety.
- This anesthetic approach may facilitate faster patient discharge.
Abstract:
Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. We describe a case of 10-year-old male patient with severe autism undergoing orchidopexy and circumcision. Following premedication, anesthesia was induced with remifentanil, propofol, atracurium, and maintained with total intravenous anesthesia (propofol and remifentanil). The Bispectral Index System was monitored for determination of the depth of anesthesia. After surgery, all infusions were discontinued. The patient was then transferred to the postanesthetic care unit. There were no adverse events observed during the anesthetic management. The patient was discharged from the hospital on the second postoperative day. Bispectral Index System-guided Total Intravenous Anesthesia can provide some advantages for patient with autism, such as hemodynamic stability, early and easy recovery, to facilitate faster discharge, to optimize the delivery of anesthetic agents, to minimize its adverse effects, and to maximize its safety.
