Volume 9, Issue 3, September 2020, Page: 58-60
Safety and Efficacy of Chloral Hydrate in Outpatient Pediatrics for Sedation
Ruijuan Qiu, Central Injection Room, The First Affiliated Hospital of Jinan University, Guangzhou, China
Guohua Huang, Central Injection Room, The First Affiliated Hospital of Jinan University, Guangzhou, China
Received: Jun. 30, 2020;       Accepted: Jul. 23, 2020;       Published: Aug. 5, 2020
DOI: 10.11648/j.sjcm.20200903.12      View  80      Downloads  49
Abstract
Objective: Sedation is frequently applied in children who need to undergo a diagnosis or treatment procedure. We aim to investigate the safety and efficacy of retention enema with chloral hydrate for the sedation of outpatient children. Methods: We retrospectively reviewed outpatient pediatric patients from March 1, 2020 to July 6, 2020, who were given an initial dose of chloral hydrate rectally for needed sedation. Patient demographics, sedation dose, onset action time, action duration time, adverse reactions were recorded. Results: In this study, totally fifty- four pediatric patients (36 males, 18 females; median [range] age, 3 [1-5] years) were sedated with chloral hydrate (median [range] dose, 70 [30-130] mg/kg). The median weight was 15 (10-21) kg, and 48 (88.9%) children was success to sedate and finished the designated examinations. Five cases (9.3%) awoke quickly and one child (1.9%) failure to fall asleep, which required rescheduling of sedation. The median action duration time of sedation was 3 (1-8) hours, and all children recovered normally post-sedation. Only 2 cases (3.7%) showed minor adverse reaction, presented as prolonged sleep. Conclusion: When strictly following the process, retention enema with chloral hydrate in pediatric patients for sedation in this study demonstrated a relatively high success rate and low risk of adverse reactions, and can be used safely and effectively for outpatient pediatrics.
Keywords
Chloral Hydrate, Sedation, Pediatrics
To cite this article
Ruijuan Qiu, Guohua Huang, Safety and Efficacy of Chloral Hydrate in Outpatient Pediatrics for Sedation, Science Journal of Clinical Medicine. Vol. 9, No. 3, 2020, pp. 58-60. doi: 10.11648/j.sjcm.20200903.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Delgado J, Toro R, Rascovsky S, et al. Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists. Pediatr Radiol. 2015; 45 (1): 108-114.
[2]
Malviya S, Voepel-Lewis T, Eldevik OP, et al. Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth. 2000; 84 (6): 743-748.
[3]
Ratnapalan S. Chloral hydrate sedation in children. Clin Pediatr (Phila). 2014; 53 (10): 933-936.
[4]
Treluyer JM, Andre C, Carp PF, et al. Sedation in children undergoing CT scan or MRI: effect of time-course and tolerance of rectal chloral hydrate. Fundam Clin Pharmacol. 2004; 18 (3): 347-350.
[5]
Heistein LC, Ramaciotti C, Scott WA, Coursey M, Sheeran PW, Lemler MS. Chloral hydrate sedation for pediatric echocardiography: physiologic responses, adverse events, and risk factors. Pediatrics. 2006; 117 (3): e434-e441.
[6]
Chen Z, Lin M, Huang Z, et al. Efficacy of chloral hydrate oral solution for sedation in pediatrics: a systematic review and meta-analysis. Drug Des Devel Ther. 2019; 13: 2643-2653.
[7]
Joo EY, Kim YJ, Park YS, et al. Intramuscular dexmedetomidine and oral chloral hydrate for pediatric sedation for electroencephalography: A propensity score-matched analysis. Paediatr Anaesth. 2020; 30 (5): 584-591.
[8]
Cheng X, Chen Z, Zhang L, et al. Efficacy and Safety of Midazolam Oral Solution for Sedative Hypnosis and Anti-anxiety in Children: A Systematic Review and Meta-Analysis. Front Pharmacol. 2020; 11: 225.
[9]
Yuen VMY, Cheuk DKL, Hui TWC, Wong ICK, Lam WWM, Irwin MG. Oral chloral hydrate versus intranasal dexmedetomidine for sedation of children undergoing computed tomography: a multicentre study. Hong Kong Med J. 2019; 25 Suppl 3 (1): 27-29.
[10]
2018 surveillance of sedation in under 19s: using sedation for diagnostic and therapeutic procedures (NICE guideline CG112). London: National Institute for Health and Care Excellence (UK); 2018.
[11]
Mace SE, Brown LA, Francis L, et al. CIinical policy: critical issues in the sedation of pediatric patients in the emergency department. J Emerg Nurs. 2008; 34 (3): e33-e107.
[12]
S. K. West, B. Griffiths, Y. Shariff, et al. Utilisation of an outpatient sedation unit in paediatric ophthalmology: safety and effectiveness of chloral hydrate in 1509 sedation episodes. Br. J. Ophthalmol. 2013; 97 (11) 1437-1442.
[13]
Necula V, Stamate MC, Blebea C, Cozma S. Safety and effectiveness of chloral hydrate in outpatient paediatric sedation for objective hearing tests. Int J Pediatr Otorhinolaryngol. 2019; 126: 109605.
[14]
Karaoui M, Varadaraj V, Munoz B, et al. Chloral Hydrate Administered by a Dedicated Sedation Service Can Be Used Safely and Effectively for Pediatric Ophthalmic Examination. Am J Ophthalmol. 2018; 192: 39-46.
[15]
Finnemore A, Toulmin H, Merchant N, et al. Chloral hydrate sedation for magnetic resonance imaging in newborn infants. Paediatr Anaesth. 2014; 24 (2): 190-195.
[16]
Allegaert K, Daniels H, Naulaers G, et al. Pharmacodynamics of chloral hydrate in former preterm infants. Eur J Pediatr. 2005; 164 (7): 403-407.
[17]
Litman RS, Soin K, Salam A. Chloral hydrate sedation in term and preterm infants: an analysis of efficacy and complications. Anesth Analg. 2010; 110 (3): 739-746.
[18]
Cozzi G, Norbedo S, Barbi E. Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate. Paediatr Drugs. 2017; 19 (2): 107-111.
Browse journals by subject