The anaesthetic management of autistic children

Related Experiment Videos

L Rainey1, J H van der Walt

  • 1Department of Paediatric Anaesthesia, Women's and Children's Hospital, Adelaide, South Australia.

Anaesthesia and Intensive Care
|January 7, 1999
PubMed

Insights

Managing autistic children in anesthesia requires specialized strategies. Oral ketamine (6-7 mg/kg) is a reliable preoperative sedative, easing patient and family stress during hospital admissions.

Area of Science:

  • Anesthesiology
  • Pediatric Care
  • Autism Spectrum Disorder Research

Background:

  • Autistic children present unique management challenges in anesthesia settings.
  • Limited research exists on anesthesia management strategies for autistic pediatric patients.
  • Conventional hospital admission processes can exacerbate stress for autistic children and their families.

Observation:

  • A case series of five autistic children undergoing anesthesia was reviewed.
  • An integrated management program was developed, considering the specific needs of autistic children and their families.
  • A system for early identification and recognition of these patients was established.
  • A database was created for ongoing program review and improvement.
  • A process was implemented to reduce stress associated with standard admission procedures.

Findings:

  • Oral ketamine, administered at 6 to 7 mg/kg, demonstrated high reliability as a preoperative sedative.
  • The integrated management program successfully addressed the special needs of autistic children and their families.
  • The early warning system facilitated timely recognition and tailored care.
  • The modified admission process minimized patient and family distress.

Implications:

  • This integrated approach offers a potential model for managing autistic children in anesthesia.
  • Oral ketamine should be considered a viable sedative option for preoperative anxiety in this population.
  • Further research into specialized anesthetic protocols for autistic children is warranted.
  • Improving the hospital experience for autistic children can lead to better outcomes and reduced family burden.

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...