Pediatric sedation: short-term effects

Slovis, Thomas L.; Parks, Christine M.; Reneau, Daniel D.; Becker, Cristie J.; Hersch, J.; Carver, C. D.; Ross, Robert D.; Tech, K.; Towbin, Richard B.

doi:10.1007/bf02011953

Cited by 33 publications

(11 citation statements)

References 12 publications

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“…I). This idea may have led to the establishment of low age limits for the use of oral chloral hydrate in the paediatric population, as reported and recommended in the literature (6,(8)(9)(10). However, in our series, failure rates were very low (<5%) for children under 36 months old, but still low (C75%) for children up to 7 years old.…”

Section: Go-20 Psupporting

confidence: 54%

Oral chloral hydrate provides effective and safe sedation in paediatric magnetic resonance imaging

et al. 1994

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Sedation is routinely required for successful Magnetic Resonance imaging in infants and children. Five hundred and ninety-six paediatric patients (270 female and 326 male, age (mean +/- SD) 41 +/- 30 months and weight 14.8 +/- 6.5 kg) entered an open, non-comparative, prospective study to assess oral chloral hydrate sedation in a large and homogeneous paediatric population undergoing Magnetic Resonance imaging. Chloral hydrate syrup 70 mg/ml was administered 20-40 min prior to the procedure. Effective sedation was reached in 94.1% with a total dose (mean +/- SEM) of 68 +/- 1 mg/kg (range 20-170 mg/kg). Statistical analysis of sedation failures vs. successful examinations after the total dose showed significant differences for dose (62 +/- 4 vs. 69 +/- 1 mg/kg; P < 0.05), age (64 +/- 7 vs. 40 +/- 1 months; P < 0.001) and weight (19.8 +/- 1.5 vs. 14.5 +/- 0.0 kg; P < 0.001). Effectiveness fell to around 80% in children with encephalic white matter alterations, medullary tumours or syringohydromyela (P = 0.07). The mean time of onset of sedation was 26 +/- 1 min, and the mean time to spontaneous awakening after the completion of the Magnetic Resonance examination was 38 +/- 2 min. Fifty-nine children (9.9%) experienced adverse reactions, with nausea and vomiting being the most common (n = 41), followed by nervousness and unusual excitement (n = 6). Discriminant function analysis identified age and total dose as the quantitative variables helping to differentiate between sedation failures and satisfactory examinations (sensitivity = 0.73, and specificity = 0.61; r = 0.20, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Go-20 Psupporting

confidence: 54%

Oral chloral hydrate provides effective and safe sedation in paediatric magnetic resonance imaging

et al. 1994

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“…However, Slovis et al . (8) found that 11 and 19% of children >8 and <8 years of age, respectively, slept more than 8 h, and 37.5% of those >8 years of age were hyperactive following PB sedation for MRI. Furthermore, these investigators reported that 3% of children who received i.v.…”

Section: Discussionmentioning

confidence: 99%

Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics

Malviya

Voepel‐Lewis

Tait

et al. 2004

Pediatric Anesthesia

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“…Dysphoria, anxiety, and agitation have been associated with the use of several sedative/hypnotic agents including the phenothiazines, benzodiazepines, barbiturates, as well as ketamine. 7,[12][13][14][15] Slovis et al 7 reported a higher incidence of hyperactivity with the use of pentobarbital (3%) compared with other sedatives. Depression of inhibitory centers in the central nervous system has been suggested as the mechanism for barbiturate induced paradoxical excitement.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Recovery and Delayed Side Effects of Sedation for Diagnostic Imaging Studies in Children

Malviya¹,

Voepel‐Lewis²,

et al. 2000

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Three hundred seventy six children comprised the sample. Eighty nine percent of children received chloral hydrate (CH; 64 +/- 13 mg/kg), and 11% midazolam (.15 +/-.13 mg/kg) as the primary sedative. There was an 8% incidence of failed sedation, and a 1.6% incidence of hypoxemia during the procedure. Three children required prolonged monitoring in the postanesthesia care unit before discharge; 1 child attributable to an allergic reaction, a second attributable to wheezing and oxygen desaturation, and the third attributable to prolonged sedation from CH and midazolam. These children were discharged home from the postanesthesia care unit without additional sequelae. Side effects after discharge included: motor imbalance (31%), gastrointestinal effects (23%), agitation (19%), and restlessness (14%). Agitation and restlessness lasted greater than 6 hours in more than one third of children who experienced these effects. CH was more commonly associated with imbalance compared with midazolam, and restlessness and prolonged imbalance were associated with younger age. Medical advice was sought after discharge for 15 (4%) children, 3 of whom required a visit to the emergency department for excessive or prolonged sedation. Each of these children had received CH as a sole sedative in recommended doses (61-77 mg/kg). In 1 of these cases, the procedure had been aborted because of inadequate sedation in the hospital, yet the child became difficult to arouse at home. Only 48% of children returned to baseline activity and behavior within 8 hours of the procedure; however, 89% were back to baseline status within 24 hours. Notably, 5% of all children did not return to baseline activity until the second day after the procedure. Although not statistically significant, infants <12 months old experienced delayed recovery (ie, >/=24 hours) more frequently compared with older c

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Pediatric sedation: short-term effects

Cited by 33 publications

References 12 publications

Oral chloral hydrate provides effective and safe sedation in paediatric magnetic resonance imaging

Oral chloral hydrate provides effective and safe sedation in paediatric magnetic resonance imaging

Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics

Prolonged Recovery and Delayed Side Effects of Sedation for Diagnostic Imaging Studies in Children

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