title: Moderate sedation for MRI in young children with autism.
abstract: Autism is a pervasive neurodevelopmental disorder. Because of the deficits associated with the condition, sedation of children with autism has been considered more challenging than sedation of other children.
  
  
  OBJECTIVE
  To test this hypothesis, we compared children with autism against clinical controls to determine differences in requirements for moderate sedation for MRI.
  
  
  METHODS
  Children ages 18-36 months with autism (group 1, n = 41) and children with no autistic behavior (group 2, n = 42) were sedated with a combination of pentobarbital and fentanyl per sedation service protocol. The sedation nurse was consistent for all patients, and all were sedated to achieve a Modified Ramsay Score of 4. Demographics and doses of sedatives were recorded and compared.
  
  
  RESULTS
  There were no sedation failures in either group. Children in group 1 (autism) were significantly older than group 2 (32.02+/-3.6 months vs 28.16+/-6.7 months) and weighed significantly more (14.87+/-2.1 kg vs 13.42+/-2.2 kg). When compared on a per-kilogram basis, however, group 1 had a significantly lower fentanyl requirement than group 2 (1.25+/-0.55 mcg/kg vs 1.57+/-0.81 mcg/kg), but no significant difference was found in pentobarbital dosing between groups 1 and 2, respectively (4.92+/-0.92 mg/kg vs 5.21+/-1.6 mg/kg).
  
  
  CONCLUSIONS
  Autistic children in this age range are not more difficult to sedate and do not require higher doses of sedative agents for noninvasive imaging studies.
authors.affiliation: Division of Pediatric Anesthesia, Duke University Medical Center, 3094, Durham, NC 27710, USA. ross0016@mc.duke.edu
authors.forename: Allison Kinder
authors.initials: AK
authors.lastname: Ross
authors.forename: Heather Cody
authors.initials: HC
authors.lastname: Hazlett
authors.forename: Nancy T
authors.initials: NT
authors.lastname: Garrett
authors.forename: Christy
authors.initials: C
authors.lastname: Wilkerson
authors.forename: Joseph
authors.initials: J
authors.lastname: Piven
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001321:Autistic Disorder; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010424:Pentobarbital / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010424:Pentobarbital; D005283:Fentanyl