Posted by: miriamjang | May 15, 2008

Dental Anasthesia For Autistic Kids

This is from an anesthesiologist who has an autistic child, and lots of experience with kids”

“For sedation dental surgery, I would use versed and propofol (dipravan) drips in the IV to titrate to the effect and they sleep through the whole thing breathing on their own with nasal cannula as long as the dentist is not using any cautery or fire-hazard equipment during the procedure, it works great.  We use alot of ketamine (family of angel-dust) for kids which vets use all the time on animals (cheap, keeps spontaneous breathing active, hemodynamic stability) but I find ketamine questionable on ASD kids since it is “dissociative anesthetic” agent (disconnects the sensory part of brain form recognizing pain), it might worsen their sensory disintegration postop.  Ketamine tends to result in nightmares and all kinds of psychiatric issues with patients postop.  Many pediatric anesthesiologists recommend Ketamine to be the choice of anesthetic for these kids and I strongly disagree.  These kids cannot complain of nightmares and strange sensations postop for days since most of them cannot communicate their intelligence appropriately as you and I know well. Please warn parents of it. Since they do not have knowledge of ASD kids or refuse to believe what we know, I find myself practicing very differently than most of the “specialists.”

This is a medical disclaimer: Please remember that this not meant as medical advice but as a desire to share information. Please always implement treatments under medical supervision. We are cannot be held liable for any of this information.

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