Analgetic Effect of Chloral Hydrate in Pain Induced by Spinal Tap in Neonates

Choi, Eun Jin; Kim, Heng Mi

Abstract

PURPOSE
The need for analgesia in neonates during and after surgery has been widely accepted in the past decade. Pain relief and sedation are still rarely used during minor treatment procedures in the neonatal intensive care units. However, many diagnostic and treatment procedures in the neonatal intensive care unit are noxious and often painful, and highly stressful for sick neonates.
METHODS
A prospective randomized clinical trial of chloral hydrate sedation in 18 neonates who received spinal tap as a routine laboratory examination for sepsis was conducted. About one hour prior to the procedure, neonates were administered 50mg/kg of chloral hydrate intrarectally. Neonates were monitored for changes of heart rate, O2 saturation, pain score. Plasma beta-endorphin level was evaluated one hour before and after the procedure. Neonates in both groups were full-term with appropriate birth weight for their gestational age. Age on study was 7 3 days in chloral hydrate group and 15+/-10 days in control group.
RESULTS
beta-endorphin level before and after procedure in chloral hydrate group was 3.15+/-0.68pmol/L and 3.6+/-0.81pmol/L prospectively. beta-endorphin level before and after procedure in control group was 3.44+/-0.68pmol/L and 2.94+/-0.57pmol/L prospectively. There were no significant changes between before and after in both groups, between chloral hydrate and control group. Pain score was higher in control group (9.6+/-2.7 vs 5.7+/-2.8 p<0.05) but incidence of hypoxic episode revealed no significant differences between chloral hydrate and control group.
CONCLUSION
The use of chloral hydrate for neonates seems not effective in reducing pain reaction associated with spinal tap.