In addition to a baseline risk for airway compromise in patients with developmental disability, Cortellazzi and colleagues showed that the risk for airway obstruction significantly increased in neurologically impaired children undergoing MRI who were administered a combination of sedative medications .
Thus, as practitioners escalate pharmacologic intervention a patient with developmental disabilities or neurologic disorders is at increased risk for airway obstruction and may need higher level of care, including the potential need for a pediatric emergency medicine specialist, anesthesiologist, or intensivist.
The overall objectives of this paper are (1) to provide an overview on recent studies that highlight the increased risk for respiratory complications following sedation and analgesia in children with developmental disabilities and neurologic disorders, (2) to provide a better understanding of sedatives and analgesic medications which are commonly used in children with developmental disabilities and neurologic disorders on the central nervous system.
With advances in health care, many children with developmental disabilities and neurologic disorders are living longer lives, and increasingly require diagnostic and therapeutic interventions.
Department of Neurobiology and Anatomy, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USAReceived 2 December 2009; Revised 15 June 2010; Accepted 20 June 2010Academic Editor: Savithiri Ratnapalan Copyright © 2010 Todd J. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sedation and analgesia performed by the pediatrician and pediatric subspecialists are becoming increasingly common for diagnostic and therapeutic purposes in children with developmental disabilities and neurologic disorders (autism, epilepsy, stroke, obstructive hydrocephalus, traumatic brain injury, intracranial hemorrhage, and hypoxic-ischemic encephalopathy).
Most reported experience refers to scattered case reports of specific syndromes (Butler et al.
Brain MRI has become an important diagnostic and management tool for these children and is being increasingly used in many pediatric centers .
Kannikeswaran and colleagues recently published a retrospective review of children, 1–18 years of age, sedated for brain MRI with and without developmental disability .
The purpose of this paper is to provide the pediatrician and pediatric subspecialist a better understanding on the neurologic effects of different sedative and analgesic medications so that rational and safe choices can be used in children with developmental disabilities and neurologic disorders without causing further “neurologic” compromise.
We performed an extensive review of the medical literature regarding sedation analgesia in children with developmental disability and neurologic disorders utilizing Pubmed.
In another study, a small observational chart review performed by Elwood et al.