Autistic children and anesthesia: is their perioperative experience different?
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Published on: July 31, 2017
Brook Arnold1, Anila Elliott2, Dean Laohamroonvorapongse2
1Northern Colorado Anesthesia Professionals, Ft. Collins, CO, USA.
Insights
Children with autism spectrum disorder (ASD) had similar perioperative experiences to those without ASD, with differences noted only in premedication types. Further research is needed to optimize care for this population.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Developmental Psychology
Background:
- Children with autism spectrum disorders (ASD) are increasingly common in perioperative settings.
- ASD is characterized by social interaction, communication, and behavioral challenges.
- These children may experience heightened perioperative anxiety, posing unique clinical challenges.
Purpose of the Study:
- To compare premedication patterns and perioperative experiences of children with and without ASD.
- To identify potential differences in complications, pain, anesthetic types, and recovery times.
Main Methods:
- Retrospective cohort study of 121 ASD patients and 881 non-ASD patients undergoing general anesthesia for dental rehabilitation (2006-2011).
- Evaluated premedication, complications, pain, anesthetic type, PACU time, and discharge time.
- Used chi-square tests and bivariate/multivariable analyses to compare groups.
Main Results:
- Children with ASD were more likely to receive nonstandard premedication (P < 0.0001).
- Children without ASD were more likely to receive standard premedication (P < 0.0001).
- No significant differences were found in complications, pain, anesthetic type, PACU time, or discharge time between groups.
Conclusions:
- Children with ASD have similar perioperative outcomes to non-ASD children, apart from premedication differences.
- The postoperative period for children with ASD did not present unique challenges.
- Further prospective studies are warranted to refine perioperative care for children with ASD.
Background:
Children with autism spectrum disorders (ASD) are an increasingly common patient population in the perioperative setting. Children with ASD present with abnormal development in social interaction, communication, and stereotyped patterns of behavior and may be more prone to elevated perioperative anxiety. The perioperative experience for these patients is complex and presents a unique challenge for clinicians.
Aim:
The aim of the current study was to provide a further understanding of the premedication patterns and perioperative experiences of children with ASD in comparison to children without ASD.
Methods:
Using a retrospective cohort study design, medical records were evaluated for patients with and without ASD undergoing general anesthesia for dental rehabilitation from 2006-2011. The following objectives were measured and compared: (i) premedication patterns and (ii) complications, pain, anesthetic type, PACU time, and time to discharge. To compare categorical variables, the chi-square test was used. Bivariate and multivariable analyses were performed to control for potential confounding as a result of baseline differences between the two groups.
Results:
A total of 121 ASD patients and 881 non-ASD patients were identified. When controlling for age, weight, and gender, children in the ASD group were more likely to have nonstandard premedication types (P < 0.0001), while children without ASD were more likely to have standard premedication types (P < 0.0001). No significant group differences were identified in regards to the other outcome measures.
Conclusions:
Other than a significant difference in the premedication type and route, we found that children with ASD seemed to have similar perioperative experiences as non-ASD subjects. It was especially interesting to find that their postoperative period did not pose any special challenges. There is much to be learned about this unique patient population, and a more in-depth prospective evaluation is warranted to help better delineate the best approach to caring for these patients.
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