Does your ASD child have to undergo a test or surgery and need to be sedated/anesthetized?

Here is a summary of the pros and cons of some commonly used anesthetics so that you can discuss with the anesthetist and choose the medication that best suits the needs of your ASD child.

nitrous oxide may present specific problems for autistic children with common underlying conditions; it depletes the B12/folate system and deactivates methionine synthase, which is an enzyme that catalyzes the conversion of homocysteine and methyltetrahydrofolate to methionine and tetrahydrofolate. Such inactivation in a patient with a defect in the MTHFR (methylenetetrahydrofolate reductase) gene, which is associated with decreased enzyme activity, could result in increased homocysteine levels, increased oxidative stress, and receptor activation. of NMDA glutamate. All of this could contribute to inflammation; In addition, nitrous oxide could also cause hematological problems, neuropathy, and neurotoxic effects.

Midazolam is a benzodiazepine medication used to induce sedation and amnesia during medical and surgical procedures. It can also be used to treat anxiety and insomnia. Midazolam is administered intravenously, orally, or intranasally. Some common side effects of midazolam include drowsiness, dizziness, weakness, and confusion.

fentanyl (it is a powerful narcotic) opioid pain reliever used to relieve moderate to severe pain. It is administered intravenously, intramuscularly, subcutaneously, transdermally (through a patch), sublingually (under the tongue), or nasally. Fentanyl is more potent than other pain-relieving drugs such as morphine and is mainly used to control pain during and after surgery or to treat severe acute and chronic pain. Some common side effects of fentanyl include sedation, dizziness, drowsiness, and nausea. Since fentanyl is a very powerful medication, it should be used with caution and only under the supervision of a doctor.

propofol a short acting agent, is administered intravenously; it is used for induction and also for maintenance of a general anesthetic (ie, keeping the patient asleep). It contains soybean oil and egg phospholipid, so that fact should be considered for patients with allergies to soybeans or eggs. Concerns have also been raised regarding the possibility that propofol exacerbated mitochondrial disease. 

the halitan it's a inhaled anesthetic gas used to induce and maintain anesthesia during surgical procedures. it is rarely used now due to its tendency to be difficult to metabolize.

THE SAFEST OPTION

Sevoflurane is an inhaled anesthetic gas used to induce and maintain anesthesia during surgical procedures. He is one of the agents. inhaled anesthetics most commonly used today due to its safety and efficacy. Sevoflurane is rapidly eliminated from the body after the surgical procedure is complete and usually leaves no residue in the body. Some potential side effects of sevoflurane include dizziness, nausea and vomiting, and headache. However, these effects are usually mild and short-lived. 

*The most important thing to discuss with your child's anesthetist is detoxification pathways. Let them know that your child could have a problem with glutathione production and have defects in the methylation pathways. A child's liver is not capable of detoxification as much as an adult's. At home, you can help that process, using the same liver detox protocols you might already be using.

Information source: Autism Research Institute.https://scholar.google.co.ve/scholar?q=Autism+Research+Institute.&hl=es&as_sdt=0&as_vis=1&oi=scholart

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