Perioperative Management and Outcomes in Patients With Autism Spectrum Disorder: A Retrospective Cohort Study
Main finding · Maximum PACU pain scoreResult — go to the resultMedian difference 0 95% CI −1.1 to 1.1Authors' conclusion
We found no difference in maximum PACU pain scores in children with ASD compared to a similarly weighted cohort without ASD. Children with ASD had higher odds of a difficult induction despite similar rates of premedication administration, and significantly higher parental and child life specialist presence at induction.
Study context
- Population
- Pediatric patients undergoing ambulatory tonsillectomy/adenoidectomy, ophthalmological surgery, general surgery, and urologic procedures, 2016–2021
- Participants
- 335 vs 11,551
- Exposure
- Children with autism spectrum disorder (ASD) vs non-ASD controls
- ASDn = 335
- Controlsn = 11,551reference
- Outcome
- Maximum PACU pain score
Methodological detailsinverse probability of treatment weighting
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
Median difference
0
95% CI −1.1 to 1.1
P = 0.66
By group
ASD
5
median · IQR 0–8
Controls
5
median · IQR 0–8
ASD vs Controls
median difference 0 (95% CI −1.1 to 1.1); P = 0.66
Observational data: associations, not effects.
Secondary outcomes
| Outcome | ASD | Controls | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Premedication use | 96% | 95% | 1.5 (0.9–2.7) | P = 0.12 | |
| Intranasal premedication | 4.2% | 1.2% | 3.5 (1.8–6.8) | P < 0.001 | |
| Parental presence at induction | 4.9% | 1.0% | 5 (2.1–12) | P < 0.001 | |
| Child life specialist presence at induction | 1.3% | 0.1% | 9.9 (2.3–43) | P < 0.001 | |
| Difficult induction | 11% | 3.4% | 3.42 (1.7–6.7) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | ASD | Controls | P value |
|---|---|---|---|
| Ketamine received | 0.3% | <0.1% | P < 0.001 |
Postoperative opioid administration, postanesthesia care unit (PACU) LOS
- No significant differences between cohorts
Safety
Emergence delirium, vomiting
- No significant differences between cohorts
Original publication
Perioperative Management and Outcomes in Patients With Autism Spectrum Disorder: A Retrospective Cohort Study. Anesth Analg. Published 3 April 2023. doi:10.
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