Efetividade da Sedação com Dexmedetomidina Intranasal para Realização de EEG em Pacientes Pediátricos com Transtorno do Espectro Autista

Abstract

Introduction: Autism Spectrum Disorder (ASD) often coexists with neurological alterations, such as epilepsy, making examinations like EEG more challenging. Pharmacological sedation, especially with intranasal dexmedetomidine, has shown promise as an alternative to ensure the necessary immobility without compromising cardiorespiratory function.Objective: This study aims to analyze the effectiveness of sedation with intranasal dexmedetomidine in children with ASD, highlighting its applicability in neurological examinations, particularly in patients with sensory and behavioral difficulties. Methodology: The literature review included studies published between 2009 and 2024, sourced from PubMed, Scielo, MedLine, and Embase. Original articles and reviews in English that addressed the use of intranasal dexmedetomidine as a sedative for EEG in children with ASD were selected. Studies not peer-reviewed, case reports, and publications in other languages were excluded. A total of 6 studies were included. Results and Discussion: Intranasal dexmedetomidine proved to be safe and effective for sedation in children with Autism Spectrum Disorder (ASD) during electroencephalograms (EEG), even in cases with challenging behavioral management. The study showed that, despite a slight age difference, there was no increase in clinical risks or adverse events, and it outperformed other sedatives. Sedation with dexmedetomidine demonstrated higher success rates and lower respiratory risk, although severe bradycardia at higher doses requires strict monitoring, especially in children with cardiac comorbidities. Conclusion: Intranasal dexmedetomidine proved to be effective and safe for sedation in children with ASD during non-painful examinations, surpassing other sedatives such as chloral hydrate and midazolam in success rates and lower respiratory risk. Although effective, episodes of bradycardia at higher doses require rigorous monitoring, especially in children with cardiac comorbidities. The studies have good quality but are limited to stable clinical contexts.