Clinical and demographic characteristics of patients with autism spectrum disorder receiving general anesthesia with or without physical restraint: a single-center retrospective study.

This study looked at 102 autistic people who needed surgery with general anesthesia. Researchers found that patients who needed physical restraint during the start of anesthesia were typically larger and more likely to show self-harm or aggressive behaviors. About 40% of patients had challenging behaviors. Most surgeries were dental procedures. Importantly, using physical restraint didn't make the anesthesia process take longer than for those who didn't need restraint.

This retrospective study examined 136 anesthetic procedures in 102 patients with autism spectrum disorder at a specialized hospital between 2019-2022. The research identified characteristics of patients requiring physical restraint during anesthesia induction, including larger body size and presence of self-injurious or aggressive behaviors. Approximately 40% of patients exhibited challenging behaviors, with dental procedures being the most common indication for anesthesia. Midazolam and pentobarbital were frequently used as premedications.

Notably, physical restraint did not prolong induction times compared to patients not requiring restraint. The study provides insights into perioperative management strategies for autistic individuals requiring general anesthesia.

Findings suggest that body size and behavioral characteristics may help predict need for physical restraint during anesthesia in ASD patients. The lack of prolonged induction times with restraint use supports its appropriate application when clinically indicated. Results may inform development of individualized perioperative protocols.

Single-center retrospective design limits generalizability. Study lacks details on specific restraint methods, severity measures of ASD, or long-term outcomes. No comparison with neurotypical patients. Sample demographics may not represent broader ASD population.

Perioperative management of patients with autism spectrum disorder (ASD) often requires premedication and physical restraint. This study examined the characteristics of patients with ASD who required special interventions for general anesthesia, particularly physical restraint during induction. This retrospective study included patients diagnosed with ASD (autism, pervasive developmental disorder, Rett syndrome, Asperger's syndrome, or childhood disintegrative disorder) based on established criteria. All patients underwent general anesthesia at a hospital for patients with disabilities between April 2019 and March 2022.

Data collected included clinical and demographic characteristics, perioperative management (premedication and anesthetic methods), surgical indications, physical restraint use, and induction time. A comparative analysis was conducted to identify differences in patient characteristics and induction times between physical restraint and no-restraint groups. Induction times were compared using Kaplan-Meier survival curves and log-rank tests. A total of 136 procedures were performed on 102 patients.

Median age was 23.3 years (interquartile range: 12.8-35.2), 79% of participants were male, and approximately 40% exhibited self-injurious or aggressive behaviors. Dental procedures were the most common indication for anesthesia. Midazolam and pentobarbital were the most frequently administered premedications. Patients requiring physical restraint were generally larger and more likely to exhibit self-injurious or aggressive behaviors than those who did not.

However, induction times were not prolonged in the physical restraint group compared with the no-restraint group. The characteristics identified in this study, such as large body size, self-injurious behavior, and aggressive behavior, may inform future research aimed at refining physical restraint use for patients with ASD.