A efetividade da sedação medicamentosa com dexmedetomidina em paciente pediátrico com transtorno do espectro autista nível iii e epilepsia: relato de caso

Abstract

INTRODUCTION: Autism Spectrum Disorder (ASD) is a set of deficiencies that affect neurodevelopment, with clinical social and behavioral signs. Patients with ASD often struggle to adapt to different situations and have hypersensitivity to sounds, different textures, and excessive object touch, explaining the difficulty in dental treatment. For better behavior management in children with ASD, it is necessary to use basic and advanced techniques, with moderate sedation being one of the most advantageous options for support and comfort for both the patient and the professional during dental procedures. OBJECTIVE: To analyze the efficacy of medicated sedation with dexmedetomidine in a patient with Autism Spectrum Disorder level III and epilepsy. METHODOLOGY: This clinical case was conducted in a male pediatric patient with ASD. The patient had a horizontal radicular fracture of the right central incisor (11) and a coronal fracture in the left central incisor (21) with pulp exposure and pain on movement. Anamnesis, photographs, and a detailed clinical examination were performed. Emergency care was provided with the assistance of moderate intranasal sedation with dexmedetomidine (Precedex). Repositioning and low-power laser application (1J) for analgesia were performed on tooth (11). For tooth (21), fragment removal, pulpotomy, temporary sealing with GIC, and fracture monitoring were carried out. RESULTS: During medicated sedation, the patient initially showed good behavior, progressing to excellent. He achieved a level of sedation initially light, evolving to moderate. The choice of dexmedetomidine provided analgesia and mild retrograde amnesia. The treatment was completed as planned without any objection or difficulty. CONCLUSION: Conditioning the behavior of an autistic patient requires meticulous care, and the application of basic and advanced techniques during treatment makes it challenging. The use of medicated sedation with Precedex proved to achieve very positive results, with better comfort for the patient and professional and lower costs and risks involved.