Chloral Hydrate, Chloral Hydrate - Promethazine and Chloral Hydrate -Hydroxyzine Efficacy in Electroencephalography Sedation

Fallah, Razieh; Alaei, Ali; Karbasi, S Akhavan; Shajari, Ahmad

doi:10.1007/s12098-013-1298-y

Cited by 16 publications

(21 citation statements)

References 27 publications

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“…Although parents are routinely instructed by our EEG laboratories staff to sleep deprive their children the day prior to their scheduled appointment, [9][10][11] spontaneous sleep is not achieved in a substantial proportion of patients. For numerous years at our institution, children referred for an EEG and who failed to sleep spontaneously were sedated with chloral hydrate (CH) after medical clearance by a pediatrician and obtaining a parental informed consent.…”

Section: Introductionmentioning

confidence: 99%

“…Children administered this drug should be constantly monitored by a nurse throughout the procedure with frequent documentations of vital signs and oxygen saturation. In order to reduce the personnel and time resources required for constant monitoring, and based on reports that melatonin and hydroxyzine are viable alternatives to CH for obtaining sleep EEG recordings, 10,11,13,14 a new sedation policy for children referred to our EEG laboratories was recently formulated and approved by our local medical committees. This policy consists of the sequential administration of melatonin, hydroxyzine (if needed), and CH (if needed) for uncooperative children or those who failed to achieve spontaneous sleep during EEG recordings.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children

et al. 2016

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Sedation of children for electroencephalography (EEG) recordings is often required. Chloral hydrate (CH) requires medical clearance and continuous monitoring. To try to reduce personnel and time resources associated with CH administration, a new sedation policy was formulated. This study included all children who underwent an EEG during a consecutive 3-month period following the implementation of the new sedation policy, which consists of the sequential administration of melatonin, hydroxyzine (if needed), and CH (if needed). The comparator group included all children with a recorded EEG during a consecutive 3-month period when the sedation policy consisted of the sole administration of CH. A total of 803 children with a mean age of 7.9 years (SD = 5.1, range = 0.5-17.7 years) were included. Sleep EEG recordings were obtained in 364 of 385 children (94.6%) using the old sedation policy and in 409 of 418 children (97.9%) using the new one. With the new sedation policy, the percentage of children requiring CH dropped from 37.1% to 6.7% (P < .001). Time to sleep onset and duration of sleep were not significantly different between the 2 policies. The new sedation policy was very well tolerated. The new sedation policy is very safe, is highly efficacious in obtaining sleep EEG recordings, and will result in substantial saving of time and personnel resources.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children

et al. 2016

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“…Currently, dexmedetomidine (intranasal, intramuscular, or intravenous) is preferred for uncooperative children or those with cognitive impairments, especially for noninvasive procedural sedation providing fewer cardiorespiratory adverse reactions with high effectiveness via various routes of administration [ 31 , 32 , 33 , 34 ]. Other sedatives including hydroxyzine and melatonin are used as common supplements for sedation in combination with CH and show favorable outcomes compared to CH alone [ 3 , 35 , 36 , 37 ]. For these reasons, the use of supplements such as hydroxyzine, melatonin, or alternative sedatives in conjunction with dexmedetomidine should be considered especially in children with epilepsy or neuropsychiatric problems with DD/ID for B-MRI sedation.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Chloral Hydrate on Brain MRI in Children with Developmental Delay/Intellectual Disability Comparing with Normal Intelligence: Single Tertiary Center Experience

Moon

Han

2021

Children

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Neurodiagnostic investigation requirements are expanding for diagnostic and therapeutic purposes in children, especially in those with developmental delay/intellectual disability (DD/ID). Thus, determination of optimal sedatives to achieve successful sedation and immobility without further neurological compromise is important in children with DD/ID. The purpose of this study is to assess the effectiveness and adverse reactions of chloral hydrate (CH) for brain magnetic resonance imaging (B-MRI) in children with DD/ID compared to those with normal intelligence (NI). We performed a retrospective chart review of children aged from 1 day to 12 years who required elective sedation using CH for B-MRI. About 730 cases (415 with DD/ID and 315 with NI) of CH sedation were conducted for B-MRI. Children with DD/ID showed a higher failure rate (22%) than did those with NI (6%); additional CH and prolonged sedation time were required. There was no difference in incidence of adverse reactions between DD/ID and NI groups (p = 0.338). Older or heavier children with DD/ID (p = 0.036 and p = 0.013, respectively), as well as those diagnosed with epilepsy or neuropsychiatric disorders showed higher risk of sedation failure (p < 0.001 for each). In conclusion, CH was a suboptimal sedative drug for children with DD/ID compared with those with NI. Other alternative or supplementary sedatives should be taken into consideration especially for those vulnerable groups.

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“…Children were given syrup Triclofos (phosphorylated derivative of chloral hydrate) 30 mg/kg for sedation which has been studied to be the most effective and safe sedation for recording EEG in children. 16 EEG was recorded using 'RMS maximus-32' for a duration of 20 minutes as per American clinical Neurophysiology guidelines for EEG recording in pediatrics. 17 Silver-Silver Chloride (Ag-AgCl) disc type electrodes of 5-7 mm diameter with long flexible lead were placed on the scalp according to the 10-20 international system with the help of "Elefix" paste.…”

Section: Methodsmentioning

confidence: 99%

A study of prevalence of abnormal EEG and its association between various clinical presentations of atypical febrile seizures

Priyavathani

Pothapregada

Varadhan³

et al. 2020

Int J Contemp Pediatr

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Background: Quantitative EEG is a rapidly emerging tool in the diagnosis and follow up of various neurological disorders and can act as predictive marker for subsequent epilepsy in children with complex febrile seizure. The present study aimed to estimate the prevalence of abnormal electroencephalogram (EEG) and to find the association between Quantitative EEG (qEEG) and various clinical features of atypical febrile seizures(AFS).Methods: EEG was recorded along with clinical features including the age at onset, duration of episode, number of episodes in a day, type of seizure and the recurrences from the children aged between 6-60 months with atypical febrile seizures. EEG recordings were classified into Normal and abnormal EEG with epileptiform changes by the expert interpretation and the distribution of above said clinical features in the both groups were analyzed. It is also attempted to find the association between qEEG and few of the clinical features.Results: Prevalence of abnormal EEG in atypical febrile seizures was 33.9%. There were no significant differences in the distribution of abnormal EEG and their association with various clinical features of AFS. Significantly increased absolute power of θ and α waves were recorded from the frontal montages in the children with epileptiform changes in the EEG.Conclusions: qEEG changes can be also considered as marker of severity of febrile seizure episodes. Many prospective studies with long-term follow up are required to establish the predictability of future epilepsy by qEEG.

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Chloral Hydrate, Chloral Hydrate - Promethazine and Chloral Hydrate -Hydroxyzine Efficacy in Electroencephalography Sedation

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

Cited by 16 publications

References 27 publications

Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children

Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children

Effectiveness of Chloral Hydrate on Brain MRI in Children with Developmental Delay/Intellectual Disability Comparing with Normal Intelligence: Single Tertiary Center Experience

A study of prevalence of abnormal EEG and its association between various clinical presentations of atypical febrile seizures

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