Paediatric Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Division of Paediatric Emergency Medicine, Children's Hospital of Geneva, Geneva University Hospitals, Geneva, Switzerland.
Acta Paediatr. 2024 Nov;113(11):2363-2377. doi: 10.1111/apa.17364. Epub 2024 Jul 31.
Management 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.
We performed a systematic review and meta-analysis of the current approaches for procedural sedation in children with ASD.
Twenty 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.
Multiple 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.
管理自闭症谱系障碍（ASD）儿童的初级保健和常规小手术可能具有挑战性；因此，当行为策略失败时，通常会使用镇静药物。我们评估了目前用于管理 ASD 儿童的药物治疗策略的有效性。
我们对 ASD 儿童程序性镇静的当前方法进行了系统评价和荟萃分析。
符合纳入标准的有 20 项研究。右美托咪定、咪达唑仑、异丙酚和水合氯醛是成功手术最有效的药物，而异丙酚发生不良事件的次数最多。最常使用的药物是右美托咪定和咪达唑仑或两者的组合，右美托咪定加咪达唑仑的效果优于单独使用右美托咪定。
对于 ASD 儿童的程序性镇静，存在多种有效的药物治疗方案。这些结果可以支持为 ASD 儿童制定特定的程序性镇静指南。
