Effectiveness of pharmacological procedural sedation in children with autism spectrum disorder: A systematic review and meta‐analysis

Author:

Zupin Luisa1ORCID,Sahyoun Cyril2,Krauss Baruch3,Dagri Arianna4,Rocco Elisabetta Maria4,Barbi Egidio14ORCID,Celsi Fulvio1

Affiliation:

1. Paediatric Department Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy

2. Division of Paediatric Emergency Medicine, Children's Hospital of Geneva Geneva University Hospitals Geneva Switzerland

3. Division of Emergency Medicine, Department of Paediatrics, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

4. Department of Medicine, Surgery and Health Sciences University of Trieste Trieste Italy

Abstract

AbstractAimManagement of primary healthcare and routine minor procedures for children with autism spectrum disorder (ASD) can be challenging; therefore, when behavioural strategies fail, sedative medications are often employed. We evaluated the effectiveness of the current pharmacological strategies for managing children with ASD.MethodsWe performed a systematic review and meta‐analysis of the current approaches for procedural sedation in children with ASD.ResultsTwenty studies met inclusion criteria. Dexmedetomidine, midazolam, propofol and chloral hydrate were the most efficient agents for successful procedures, while propofol had the highest number of adverse events. The most frequently used agents were dexmedetomidine and midazolam or a combination of the two, and the effectiveness of dexmedetomidine plus midazolam was superior to dexmedetomidine alone.ConclusionMultiple effective drug regimens exist for procedural sedation in children with ASD. These results could support the development of specific guidelines for procedural sedation in children with ASD.

Publisher

Wiley

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