Moderate sedation for MRI in young children with autism.
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.
Ross
Allison Kinder
AK
Division of Pediatric Anesthesia, Duke University Medical Center, 3094, Durham, NC 27710, USA. ross0016@mc.duke.edu
Hazlett
Heather Cody
HC
Garrett
Nancy T
NT
Wilkerson
Christy
C
Piven
Joseph
J
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
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010424:Pentobarbital; D005283:Fentanyl