93% of Patients Required No Physical Restraint, and 98% Successfully Completed Healthcare Procedures
An international research team recently set out to help parents of children with autism spectrum disorder (ASD) or developmental delay (DD) manage routine medical appointments, which are often traumatic for children with special needs. They developed a sedation method involving home desensitization to intranasal drug delivery, environmental modification, and intranasal dexmedetomidine combined with nitrous oxide (n2o). The protocol was specifically developed for children ages 2 to 16 who met specific cognitive and anesthesiology criteria. The researcher’s integrated approach involved emailing instructions on introducing their child to an intranasal-delivered substance to parents a week before a scheduled procedure. After becoming familiar with the instructions, the parents administered a saline solution to their child’s nostrils two to three times a day at home, where their children feel the least stressed. Upon arrival for their scheduled procedures, parents administered intranasal dexmedetomidine to their children with supervision by clinicians through a mucosal atomizer device. The procedure rooms were designed to be as quiet and non-stimulating as possible. The children were then encouraged to use mobile phones or tablets loaded with their favorite activities in the procedure room. Sleeping conditions were maximized by dimming lights, speaking only in whispers and placing children in their preferred sleeping positions. Once the children fell asleep, parents applied an unscented face mask delivering a free-flowing mixture of 50% n2o and 50% oxygen. The protocol worked incredibly well. Results showed that 93% of the children required no physical restraint, and the medical procedures were successfully completed in 98% of the patients. The authors found the drug regimen used in this protocol as well-tolerated, safe, and effective. They encourage future research on this approach that compares it to other sedation techniques.
