Patient Management
Purvi Patel, DMD (she/her/hers)
Pediatric Dental Resident
New York University College of Dentistry, New York, NY
New York University College of Dentistry, New York, NY
New York, New York, United States
Caroline M. Sawicki, DDS, PhD
New York University College of Dentistry
Sheena Nandi, DDS
New York City Health and Hospitals/Bellevue
Lauren M. Feldman, DMD, MPH
Postdoctoral Program Director
New York University College of Dentistry
New York, New York, United States
Spencer Wade, DDS, MS
Dentist Anesthesiologist
New York University, New York, NY
New York University
New York, New York, United States
Purpose: The purpose of this study was to compare the perioperative experience of pediatric patients with and without autism spectrum disorder (ASD) undergoing comprehensive dental treatment under general anesthesia (GA).
Methods: Records of pediatric patients treated under GA from April 1, 2019 to April 1, 2020 were reviewed. The control group consisted of randomly selected neurotypical children who were treated under GA in the same time period and hospital. Pre-, intra-, and postoperative medications used during surgery were compared between groups, additionally total time spent in post anesthesia care unit, dental procedure start and finish times as well as time of intubation and extubation. Data on presence or absence of post operative nausea, vomiting and the anesthesiologist’s pain scale rating were collected for all patients.
Results: The sample consisted of 39 patients with ASD and 46 neurotypical children. More patients with ASD were male (P>.0366) and older (P>.0002) compared to non-ASD patients. The total time to complete all dental procedures was slightly higher in the healthy patient population (P>.068). Midazolam was used more commonly in patients with ASD intraoperatively (P>.0002). No significant group differences were found for the other outcome measures.
Conclusions: Findings from this study suggest that the perioperative management of pediatric patients with ASD is similar to that of neurotypical children, besides from a significant difference in intraoperative medication use. A better understanding of the anesthetic considerations of children with ASD may help facilitate the development of an individualized perioperative management plan for this unique patient population.