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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and restricted and repetitive patterns of behaviors. The special needs of this population bring unique challenges to their medical care. Children with ASD often have sensory sensitivities, anxieties, irritability, and aggressive behaviors that require consideration of varying levels of sedation to safely undergo outpatient procedures. As the prevalence rises with increase in recognition, sedation providers need to be increasingly familiar with this population to minimize peri-procedural problems. Planning for procedures and sedation should include active pre-procedure planning by sedation unit staff aimed at understanding baseline behaviors and triggers, strategies such as using social stories and active parental engagement to familiarize the child and the parents with the procedure, arranging for early morning procedures and having the child recover in a familiar environment. Medication responses are similar to those described in children without ASD but providers should be prepared to utilize greater degrees of pre-procedure premedication to minimize worsening of anxiety, mitigate aggressive behavior, and sedate more deeply for procedures often not requiring sedation in other populations. With appropriate planning and collaboration between the treatment team with caregivers, patients with ASD can be safely and successfully sedated for both invasive and noninvasive procedures in multiple environments including the sedation unit, dental suites, and emergency departments. |
