The Role of Nurse Anesthetists in Caring for Patients with Autism Undergoing Dental Treatment under General Anesthesia
DOI:
https://doi.org/10.64767/trcn.2025.275367Keywords:
nurse anesthetist, autistic, patients, dental treatment, general anesthesiaAbstract
Dental treatment using anasthesia is considered an effective approach for individuals with autism spectrum disorder, as it enables dentists to provide comprehensive and effective dental treatment while reducing the risks associated with treatment resistance. This approach presents a significant challenge for nurse anesthetists because individuals with autism may have impairments in communication, social interaction, and emotional control, and may display aggressive and uncooperative behavior. In addition, autistic patients frequently present with mental and physical comorbidities such as attention deficit hyperactivity disorder (ADHD), anxiety disorders, epilepsy, and obesity, which may increase the risk of complications following dental treatment. Nurse anesthetists should provide pre-anesthesia care and monitoring both during and after general anesthesia to ensure the safety of the patient and minimize complications following the use of general anesthesia in dental treatment. In addition, nurse anesthetists play a crucial role as nurse practitioners, safety managers, educators, and quality developers of anesthesia services.
This article aims to present knowledge and promote understanding about the definition of autism; the causes and factors contributing to autism; the diagnosis and severity of autism; comorbidities and disorders in autistic individuals; oral health issues in autistic individuals; dental treatment for autistic individuals and its limitations; and complications regarding general anesthesia in autistic individuals in terms of nursing practice, diagnosis, planning, nursing and evaluation. Emphasis is placed on the important role of nurse anesthetists in caring for patients with autism undergoing treatment under general anesthesia, with the aim of providing effective anesthesia nursing guidelines based on the nursing process.
References
Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr 2022 8;48(1):112.
Department of mental health. It is revealed that Thailand has 18,220 autistic individuals, with less than 100 having jobs and income [Internet]. 2018 [cited 2024 Dec 5]. Available from: https://dmh.go.th/news-dmh/view.asp?id=27771 (in Thai)
Ongartsakulmun R, Muensunthorn S. Chammak C. Prevalence of autism spectrum disorder in Thai children aged 1-4 years [Internet]. 2020 [cited 2024 Dec 18]. Available from: https://ycap.go.th/research/318- (in Thai)
Lugo-Marín J, Magan-Maganto M, Rivero-Santana A, Cuellar-Pompa L, Alviani M, Jenaro-Rio C, et al. Prevalence of psychiatric disorders in adults with autism spectrum disorder: a systematic review and meta-analysis. Res Autism Spectr Disord 2019;59:22-33.
Anesthesiology Unit, Dental Hospital. Minutes of the Monthly Anesthesiology Unit Meeting, January 2025 [Internal document]. Bangkok: Dental Hospital; 2025. (in Thai)
Kanner L. Autistic disturbances of affective contact. Nervous Child 1943;32:217-50.
American Psychiatric Association. Autism spectrum disorder. In: American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed. Washington (DC): American Psychiatric Association Publishing; 2022. p. 56-8.
Sauer AK, Stanton JE, Hans S, Grabrucker AM. Autism spectrum disorders: etiology and pathology. In: Grabrucker AM, editor. Autism spectrum disorders. Brisbane (AU): Exon Publications; 2021. p. 1-15.
Al-Beltagi M. Autism medical comorbidities. World J Clin Pediatr 2021;10(3):15-28.
Prato A, Saia F, Ferrigno M, Finocchiaro V, Barone R, Rizzo R. Sensory phenomena in children with Tourette syndrome or autism spectrum disorder. Front Psychiatry 2024;15:1338234.
Hupp JR, Ellis E 3rd, Tucker MR, editors. Contemporary oral and maxillofacial surgery. 7th ed. St. Louis (MO): Elsevier; 2022.
Lai CC, Wu CC. Caries pattern and dental treatment features of children with autism spectrum disorder under general anesthesia. Medicine (Baltimore) 2025;104(12):e41867.
Cortese S, Adamo N, Del Giovane C, Mohr-Jensen C, Hayes AJ, Carucci S, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 2018;5(9):727-38.
Wongyingsin M. Anesthesia for obese patients. In: Srirach W, Poolnitiporn A, Yokubon B, editor, editor. Advanced anesthesia 4.0 Vol 2. Bangkok: Thana Press; 2019. p. 279-99. (in Thai)
Janboontai T. Postoperative nausea and vomiting. In: Saengrung R, Traisunan N, Saengthongjarasakul S, Teerasunthornwong W, editors. Integrated anesthesia care vol. 2. Bangkok: P.A. Living; 2025. p.247-70. (in Thai)
Nagelhout JJ, Plaus KL. Nurse anesthesia. 6th ed. St. Louis: Elsevier; 2018.
Kooncharoensuk Y. Comprehensive patient assessment. In: Royal College of Anesthesiologists of Thailand, editor. Advanced anesthesia 4.0. Bangkok: Thana Press; 2019. p. 33-42. (in Thai)
Perers C, Backstrom B, Johansson BA, Rask O. Methods and strategies for reducing seclusion and restraint in child and adolescent psychiatric inpatient care. Psychiatr Q 2022;93(1):107-36.
Phumhiran P. Post-anesthesia patient care. In: Rueanonukul N. Yokubon B. Rodanan O. Duangrat T. Contemporary anesthesia care. Bangkok: Thanapress; 2018. p. 305-10. (in Thai)
Sathira-Angkura T, Khwansathapornkul K, Wongsuvansiri S, Kladjompong P. Organization of nursing services for advanced practice nurse. In: Sathira-Angkura T, Khwansathapornkul K, Wongsuvansiri S, Kladjompong P. Guidelines for advanced practice nursing services. Nonthaburi: Nursing Division, Office of the Permanent Secretary, Ministry of Public Health; 2013. p. 29-60. (in Thai)
Upasri T, Prachusilpa G. A study of nurse anesthetist roles. Journal of The Royal Thai Army Nurses 2020;23(1):494-501. (in Thai)
Pann KJ, Buchner VK, EBl-Maurer R, Bacher T, Glarcher M, Ewers A. International competencies of nurses with advanced practice in anesthesia nursing: an integrative review. Int J Nurs Stud Adv 2025;8:100319.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Srisavarindhira Thai Red Cross Institute of Nursing

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
เนื้อหาบทความหรือข้อคิดเห็นต่างๆ ในวารสารพยาบาลสภากาชาดไทยนี้ เป็นความคิดเห็นของผู้เขียนบทความ ไม่ใช่ความเห็นของกองบรรณาธิการ หรือสถาบันการพยาบาลศรีสวรินทิรา สภากาชาดไทย