
Anesthesia and Sedation Options for Kids with Autism
Does your child with ASD need sedation for a dental or surgical procedure? Wondering what your options are? Anesthesia and sedation choices need to be carefully considered for a child with complex medical needs.
Why Is This So Important?
Nitrous Oxide
Sevoflurane
Versed
Propofol
The delivery for propofol is intravenous. Its function is to induce and maintain general anesthesia and a safe airway. Please note that it contains soy and egg phospholipids. If your child has an allergy or sensitivity to either of those be sure to let your provider know. It may exacerbate mitochondrial issues when used for longer periods. However, our nurse stated that a small bolus is okay for children over 65-70 pounds.
Definitely discuss any concerns with your provider and anesthesiologist. For more detailed information please see our link below for “When Propofol is Problematic”.
Ketamine
Precedex
Precedex, also called Dexmedetomidine, is an intravenous drug for sedation. It is not approved for use in children in any country according to the article linked in the resources below. It is often used off-label anyway. Studies of its potential negative effects in children are limited and sometimes conflicting. Precedex is sometimes associated with low heart rates and unsafe blood pressure changes. In recovery, patients may experience and pain, shivering, and agitation. Lily decided to avoid this one with Bear for the reasons listed above. We encourage you to do your research before you speak with your anesthesiologist. Understand the risks so you can ask good questions.
Lactated Ringers
Sometimes called ringers lactate. This is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It’s given through the IV during surgical procedures to help replace electrolytes. Kids with mitochondrial issues are at risk for lactic acidosis. Lactated ringers in the IV make this condition worse or more likely.
Additional Information and Resource Links
- Risk of Anesthesia Regression in Children with Autism Spectrum Disorder and Mitochondrial Dysfunction
- Anesthesia & ASD by Sym C. Rankin, RN, CRNA
- When Nitrous Oxide is No Laughing Matter
by Victor C. Baum, M.D. - Anesthesia for children with special needs, including autistic spectrum disorder
- When Propofol is Problematic – The Society for Pediatric Anesthesia
- How Long Does Versed Stay In Your System
- Mitochondrial Disease and Anesthesia
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What would you advice for an 8 yrs old having to have 3 decade baby teeth out with anesethia