Chloral hydrate, chloral hydrate--promethazine and chloral hydrate -hydroxyzine efficacy in electroencephalography sedation

Indian J Pediatr. 2014 Jun;81(6):541-6. doi: 10.1007/s12098-013-1298-y. Epub 2014 Jan 21.

Abstract

Objective: To compare efficacy and safety of chloral hydrate (CH), chloral hydrate and promethazine (CH + P) and chloral hydrate and hydroxyzine (CH + H) in electroencephalography (EEG) sedation.

Methods: In a parallel single-blinded randomized clinical trial, ninety 1-7 y-old uncooperative kids who were referred to Pediatric Neurology Clinic of Shahid Sadoughi University, Yazd, Iran from April through August 2012, were randomly assigned to receive 40 mg/kg of chloral hydrate or 40 mg/kg of chloral hydrate and 1 mg/kg of promethazine or 40 mg/kg of chloral hydrate and 2 mg/kg of hydroxyzine. The primary endpoint was efficacy in sufficient sedation (obtaining four Ramsay sedation score) and successful completion of EEG. Secondary endpoint was clinical adverse events.

Results: Thirty nine girls (43.3 %) and 51 boys (56.7 %) with mean age of 3.34 ± 1.47 y were assessed. Sufficient sedation and completion of EEG were achieved in 70 % (N = 21) of chloral hydrate group, in 83.3 % (N = 25) of CH + H group and in 96.7 % (N = 29) of CH + P group (p = 0.02). Mild clinical adverse events including vomiting [16.7 % (N = 5) in CH, 6.7 % (N = 2) in CH + P, 6.7 % (N = 2) in CH + H], agitation in 3.3 % of CH + P (N = 1) group and mild transient hypotension in 3.3 % of CH + H (N = 1) group occurred. Safety of these three sedation regimens was not statistically significant different (p = 0.14).

Conclusions: Combination of chloral hydrate-antihistamines can be used as the most effective and safe sedation regimen in drug induced sleep electroencephalography of kids.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Child, Preschool
  • Chloral Hydrate / administration & dosage*
  • Conscious Sedation*
  • Drug Therapy, Combination
  • Electroencephalography*
  • Female
  • Humans
  • Hydroxyzine / administration & dosage*
  • Hypnotics and Sedatives / administration & dosage*
  • Infant
  • Male
  • Promethazine / administration & dosage*
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Hypnotics and Sedatives
  • Hydroxyzine
  • Chloral Hydrate
  • Promethazine