Rectal chloral hydrate sedation for computed tomography in young children with head trauma

Abstract

Children evaluated in the emergency department for head trauma often undergo computed tomography (CT), with some uncooperative children requiring pharmacological sedation. Chloral hydrate (CH) is a sedative that has been widely used, but its rectal use for child sedation after head trauma has rarely been studied. The objective of this study was to document the safety and efficacy of rectal CH sedation for cranial CT in young children. We retrospectively studied all the children with head trauma who received rectal CH sedation for CT in the emergency department from 2016 to 2019. CH was administered rectally at a dose of 50 mg/kg body weight. When sedation was achieved, CT scanning was performed, and the children were monitored until recovery. The sedative safety and efficacy were analyzed. A total of 135 children were enrolled in the study group, and the mean age was 16.05 months. The mean onset time was 16.41 minutes. Successful sedation occurred in 97.0% of children. The mean recovery time was 71.59 minutes. All of the vital signs were within normal limits after sedation, except 1 (0.7%) with transient hypoxia. There was no drug-related vomiting reaction in the study group. Adverse effects occurred in 11 patients (8.1%), but all recovered completely. Compared with oral CH sedation, rectal CH sedation was associated with quicker onset ( P < .01), higher success rate ( P < .01), and lower adverse event rate ( P < .01). Rectal CH sedation can be a safe and effective method for CT imaging of young children with head trauma in the emergency department.

Efficacy and safety of ketamine alone and ketamine‐dexmedetomidine combination for sedation for brain computed tomography in paediatric patients with head injuries: A retrospective study

“…Annually, more than 600 000 paediatric patients visit the emergency room in the USA; further, approximately 18 000 patients experience traumatic brain injury. 1,2 From 2014 to 2016, approximately 20% of 257 661 patients with traumatic brain injury aged <14 years underwent brain CT. 3 Despite recent advances in high-speed CT, patients still require movement restrictions to obtain accurate test results. Therefore, some children who need a CT scan but are uncooperative may require sedation.…”

“…Annually, more than 600 000 paediatric patients visit the emergency room in the USA; further, approximately 18 000 patients experience traumatic brain injury 1,2 . From 2014 to 2016, approximately 20% of 257 661 patients with traumatic brain injury aged <14 years underwent brain CT 3 .…”