Sedação e seus riscos potenciais em crianças com espectro autista em decorrência de sobreposições medicamentosas: revisão crítica

Abstract

Objective: to analyze the pharmacological overlap in patients with autism spectrum disorder (ASD) undergoing conscious sedation in a dental environment, identifying the potential risk and complication. Method: A critical review was performed by selecting articles from online databases (Pubmed and Lilacs), using a search algorithm and eligibility criteria. To verify drug interactions between drugs commonly used by patients with ASD and drugs used in sedation in Pediatric Dentistry, the Medscape® platform was used. Results: It was verified that the child with ASD, due to polydrug use, has risks of complications due to the pre-existence of metabolic syndrome, deepening of the sedative plan or even decreasing the sedative capacity of drugs used for sedation, serotoninergic syndrome, neuroleptic malignant syndrome, increase or decrease in the QT interval (iQT) and Torsade de Pointes. Final considerations: Moderate sedation in a dental environment for children with autism should be encouraged, as the improvement in assertiveness and speed of treatment increases the quality of life of this patient. Sedation planning should be individualized, considering the particularities of each patient, such as the severity of the disorder, associated cooccurrences and the pharmacological regimen used by that child, so that there is a decrease or cessation of adverse reactions resulting from such pharmacological interactions. The use of digital platforms, such as Medscape®'s Drug Interaction Checker, to assess the interaction between two or more drugs in the context of moderate sedation should be done in a thoughtful way and associated with continuous learning about sedation, pediatric dentistry, emergency procedures and child patient support in the dental environment.