Anesth Pain Med.  2016 Oct;11(4):366-374. 10.17085/apm.2016.11.4.366.

Assessment of chloral hydrate-centered pediatric sedation performed by non-anesthesiologists

• Kim YS
• Lim BG
• Kang SW
• Lee SH
• Lee W
• Lee IO

• KMID: 2358333
• DOI: http://doi.org/10.17085/apm.2016.11.4.366

Abstract

BACKGROUND
We aimed to evaluate the efficacy and safety of chloral hydrate-based pediatric sedation conducted by non-anesthesiologists.
METHODS
The design and setting of this study was a single-center retrospective study performed at a tertiary university hospital between July 2012 and May 2013. A total of 519 children were enrolled in this study. We investigated the sedation medication, age of patients and type of diagnostic tests or procedures and evaluated the success rate of sedation, sedation/recovery profiles and adverse events.
RESULTS
Most patients underwent moderate sedation for diagnostic tests. The most commonly used sedative drug was chloral hydrate, which was solely used for 482 patients. A combination of chloral hydrate/midazolam was used for 24 patients and midazolam only was used for 13 patients. Use of chloral hydrate resulted in a sedation success rate of 65.5% after the initial dose and a success rate of 95.2% with additional doses. The sedation failure rate in children > 6 years was significantly higher than that in children under 6 years. In all patients, the overall onset time and recovery time were too slow and long, respectively, and there was no critical complication.
CONCLUSIONS
This study demonstrated that chloral hydrate-based pediatric sedation conducted by non-anesthesiologists was mostly moderate, with a high success rate and a low complication rate. However, the overall onset time and recovery time were too slow and long, respectively. Especially, alternative sedation regimens are required in children > 6 years considering the slower onset time and higher failure rate of sedation.

Keyword

Child; Chloral hydrate; Midazolam; Non-anesthesiologists; Sedation

MeSH Terms

Child
Chloral Hydrate
Conscious Sedation
Diagnostic Tests, Routine
Humans
Midazolam
Retrospective Studies
Chloral Hydrate
Midazolam

Figure

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  Fig. 1 The receiver operating characteristic (ROC) curve for predicting the failure or success of sedation. This curve shows the area under the curve (AUC) of 0.732 and the cut-off value of age of 4.79 years (sensitivity 0.696, specificity 0.776) (P < 0.001).

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