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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).
These findings seem to recapitulate the findings described in the PSRC studies: an increase in adverse events, most notably airway compromise, for children with developmental disabilities and those with neurologic disorders.In this study, the most common diagnosis for the cause of developmental disability was autism (36%).In addition, the authors included patients with attention deficit hyperactivity disorder (20%) as a diagnosis for developmental disability.With this practice increasing, the debate about safety and the practitioner core competency requirements to provide sedation and/or analgesia to the complex pediatric patient with developmental disabilities and neurologic disorders has also increased and several policy statements have been published by different professional societies , with no clear evidence of practice standards and incidence of adverse outcomes.To aid in the investigation of the practice and potential adverse outcomes associated with the delivery of sedation outside the operating room, the Pediatric Sedation Research Consortium (PSRC), a collection of 37 institutions that share information on sedation practices within their individual institutions, has created a self-reporting prospective, observational database.