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was not disclosed to the anesthesia team until after the incident. The patient's last seizure was 9 months prior to the appointment. His home medications consisted of the following: albuterol inhaler (twice a day [BID] as needed), fluvoxamine (150 mg, 3 times a day [TID]), paroxetine (40 mg, every night at bedtime [qhs]), extended-release guanfacine (1 mg, TID), haloperidol (5 mg, BID), olanzapine (10 mg, BID), ziprasidone (60 mg, BID), lacosamide (100 mg, BID), lamotrigine (200 mg, BID), zonisamide (100 mg, BID), propranolol (20 mg, TID), black cohosh (qhs

acting α 2 adrenergic agonists, such as guanfacine 18 or clonidine, 19 for improved control of sleep and behavior disorders. The behavioral impact of dexmedetomidine in patients with ASD may be most notable during emergence from GA, where dexmedetomidine is reported to reduce emergence agitation. 20 Due to its retrospective nature, our study had several limitations. Due to a lack of randomization, those who received dexmedetomidine may have differed from those who did not in ways not captured by the demographic analysis. The anesthesia EMR used in this study

. Synaptic influences of α-1 and α-2 receptors. Postjunctional α-1 receptors mediate effects on target tissues whereas prejunctional α-2 receptors inhibit neurotransmitter release and provide negative feedback. Guanabenz, guanfacine, clonidine, tizanidine, medetomidine, and dexmedetomidine are all α-2 agonists that vary in their potency and affinities for the various α-2 receptor subtypes. Clonidine, tizanidine, and dexmedetomidine have received the greatest clinical use and will be addressed more thoroughly. Summary data are provided in Table 2

, Dinenno FA, Joyner MJ, Eisenach JH. Selective alpha2-adrenergic properties of dexmedetomidine over clonidine in the human forearm . J Appl Physiol . 2005 ; 99 : 587 – 592 . 20 Butterworth JF 5th, Strichartz GR . The alpha 2-adrenergic agonists clonidine and guanfacine produce tonic and phasic block of conduction in rat sciatic nerve fibers