Dr. Sawicki is a pediatric dentistry resident and post-doctoral research fellow, Department of Pediatric Dentistry, New York University College of Dentistry, New York, N. Y., USA.
Dr. Pielech is an assistant professor and licensed clinical psychologist, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, R. I., USA.
Pediatr Dent. 2023 Jan 15;45(1):37-53.
The purpose of this study was to evaluate practice patterns among dentist anesthesiologists for pediatric patients with autism spectrum disorders (ASD) undergoing sedation for dental procedures.
An electronic nationwide survey was delivered to all members of the American Society of Dentist Anesthesiologists. The survey assessed provider training and comfort in treating pediatric patients with ASD, perioperative procedures for children with and without ASD, and preferred educational resources for the perioperative management of pediatric patients with ASD.
Respondents were 114 dentist anesthesiologists and residents (33.3 percent response rate). Respondents indicated a high comfort level for managing pediatric patients with ASD for sedation (mean equals 91.9±14.74 [SD] percent). The average number of patients with ASD who respondents treat per week was 3.48±2.44). Providers reported making scheduling and staffing accommodations for patients with ASD. More than half of respondents reported no difference between patient groups in medication dosing for sedation and medication regimens used intraoperatively; however, only 43.9 percent of providers indicated using equivalent preoperative medication regimens for both patient groups, and providers reported increased usage of preoperative anxiolytic techniques with patients with ASD. Importantly, 87.7 percent of respondents reported the same incidence of adverse events during the perioperative period between groups.
Findings from this survey suggest there are both similarities and differences in how dentist anesthesiologists practice with pediatric patients with and without autism spectrum disorders. Additional research is warranted to measure the clinical benefits of modified practices for patients with ASD and identify best practices for this vulnerable population.
本研究旨在评估牙医麻醉师在为自闭症谱系障碍(ASD)儿童进行镇静牙科治疗时的实践模式。
向美国牙医麻醉师协会的所有成员发送了一份电子全国性调查。该调查评估了提供者在治疗 ASD 儿童方面的培训和舒适度、ASD 儿童和非 ASD 儿童的围手术期程序以及 ASD 儿童围手术期管理的首选教育资源。
受访者为 114 名牙医麻醉师和住院医师(回应率为 33.3%)。受访者表示在管理 ASD 儿童镇静方面的舒适度很高(平均为 91.9±14.74[SD]%)。受访者每周治疗的 ASD 儿童平均人数为 3.48±2.44)。提供者报告为 ASD 患者做出了调度和人员配备方面的调整。超过一半的受访者报告称,在镇静药物剂量和术中使用的药物方案方面,两组患者之间没有差异;然而,只有 43.9%的提供者表示两组患者都使用了等效的术前药物方案,并且提供者报告说,在 ASD 患者中增加了术前抗焦虑技术的使用。重要的是,87.7%的受访者报告两组患者在围手术期期间发生不良事件的发生率相同。
本调查结果表明,牙医麻醉师在治疗患有和不患有自闭症谱系障碍的儿科患者方面既有相似之处,也有不同之处。需要进一步研究来衡量针对 ASD 患者的改良实践的临床益处,并确定针对这一弱势群体的最佳实践。