Comparison of Procedural Sedation Outcomes in Children With and Without Autism Spectrum Disorder

Area of Science:

• Pediatric Anesthesiology
• Neurodevelopmental Disorders
• Patient Safety

Background:

• Children with autism spectrum disorder (ASD) often have comorbidities that increase risks during sedation.
• Sedation-related adverse events (AEs) are a concern in pediatric populations, particularly those with underlying health conditions.

Purpose of the Study:

• To compare the incidence and types of sedation-related AEs in children with and without ASD.
• To identify specific risks associated with sedation in children diagnosed with ASD.

Main Methods:

• A multicenter study analyzed data from the Pediatric Sedation Research Consortium database (May 2022-April 2023).
• Children aged 3-18 years with and without ASD undergoing non-operating room sedation were compared.
• Analysis involved matching participants based on age, sex, procedure, and ASA classification to control for confounding factors.

Main Results:

• Out of 64,708 children, 6.8% had an ASD diagnosis, with higher rates of male sex, obesity, and comorbidities.
• Matched analysis revealed no significant difference in critical AEs (OR, 0.63; 95% CI, 0.23-1.49).
• Children with ASD showed increased odds of high-risk (OR, 1.52; 95% CI, 1.26-1.83) and low-risk AEs (OR, 1.39; 95% CI, 1.25-1.55), including hypoxia and airway obstruction.

Conclusions:

• Children with ASD are at a significantly higher risk for sedation-related airway adverse events.
• Increased odds of hypoxia and airway obstruction (complete and partial) were observed in children with ASD.
• While critical AEs were infrequent, the study highlights the need for careful monitoring and management of respiratory events during sedation in children with ASD.