ArticleJournal of anesthesia2026
Clinical and demographic characteristics of patients with autism spectrum disorder receiving general anesthesia with or without physical restraint: a single-center retrospective study.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePerioperative management of patients with autism spectrum disorder (ASD) often requires premedication and physical restraint. This study examined the characteristics of patients with ASD who required special interventions for general anesthesia, particularly physical restraint during induction.
methodThis retrospective study included patients diagnosed with ASD (autism, pervasive developmental disorder, Rett syndrome, Asperger's syndrome, or childhood disintegrative disorder) based on established criteria. All patients underwent general anesthesia at a hospital for patients with disabilities between April 2019 and March 2022. Data collected included clinical and demographic characteristics, perioperative management (premedication and anesthetic methods), surgical indications, physical restraint use, and induction time. A comparative analysis was conducted to identify differences in patient characteristics and induction times between physical restraint and no-restraint groups. Induction times were compared using Kaplan-Meier survival curves and log-rank tests.
resultsA total of 136 procedures were performed on 102 patients. Median age was 23.3 years (interquartile range: 12.8-35.2), 79% of participants were male, and approximately 40% exhibited self-injurious or aggressive behaviors. Dental procedures were the most common indication for anesthesia. Midazolam and pentobarbital were the most frequently administered premedications. Patients requiring physical restraint were generally larger and more likely to exhibit self-injurious or aggressive behaviors than those who did not. However, induction times were not prolonged in the physical restraint group compared with the no-restraint group.
conclusionThe characteristics identified in this study, such as large body size, self-injurious behavior, and aggressive behavior, may inform future research aimed at refining physical restraint use for patients with ASD.
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