Evaluation of Conscious Intramuscular Sedation in Children With Autism Spectrum Disorder Undergoing Outpatient Dental...

To evaluate the safety and efficacy of a conscious intramuscular (IM) sedation protocol combined with inhalational sedation in children with autism spectrum disorder (ASD) undergoing outpatient dental treatment, based on clinical data and dentists' perceptions.

Thirty-seven sedation appointments in 28 patients with ASD were analyzed. Patients received an IM protocol of midazolam 0.1 mg/kg, ketamine 0.7 mg/kg, dexmedetomidine 0.5 mcg/kg, and promethazine 0.3 mg/kg. Data collection included demographics, support needs, use of central nervous system (CNS) depressants, procedures performed, adverse events, sedation time, clinicians' assessments, and vital signs. Most patients were males (68%); aged 3-12 years and 65% required Level III support. CNS depressants were routinely used in 66% of cases. Surgical procedures occurred in 46% of appointments, and mean sedation time was 40 min. Only five (14%) adverse events were observed, and clinicians rated sedation as excellent in 62% of cases. Vital signs showed minimal variation throughout sedation. No statistically significant association were found between CNS depressant use and adverse events or between sedation success and sex, age, support level, or procedure characteristics.

This IM sedation protocol appears safe and effective for outpatient dental care in individuals with ASD. Further research is needed to expand equitable access to sedation-based care.