Chloral hydrate and/or hydroxyzine for sedation in pediatric EEG recording

Bektaş, Ömer; Arica, B; Teber, Serap; Yılmaz, Ayşegül; Zeybek, Hediye; Kaymak, Selda; Deda, Gülhıs

doi:10.1016/j.braindev.2013.03.002

Cited by 21 publications

(26 citation statements)

References 15 publications

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“…Besides triclofos and chloral hydrate, hydroxyzine (long-acting first generation H1 antagonist),[ 5 6 ] oral midazolam,[ 7 ] and melatonin (pineal hormone regulating the sleep wake cycle)[ 8 ] have been used recently. Their results have been summarized in Table 3 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of oral triclofos as sedative for children undergoing sleep electroencephalogram: An observational study

Jain

Sharma

et al. 2016

J Pediatr Neurosci

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Objectives:Triclofos may be a better sedative in view of better palatability and less gastric irritation as compared to chloral hydrate. This study aimed to assess the efficacy of triclofos (a commonly used sedative in India) as a sedative for sleep electroencephalogram (EEG) study in children.Methods:This prospective observational study was carried out in a tertiary care pediatric center. Consecutive children aged 6 months to 5 years referred for sleep EEG evaluation were recruited. Their clinical details were noted in a proforma after an informed consent. After a trial for natural sleep, oral triclofos was administered. Sleep parameters and adverse effects were noted.Results:One-hundred and sixty children were then enrolled. EEG was successfully recorded in 149 (93.1%) children. Median latency of sleep onset was 30 min and median duration of sleep was 90 min. The adverse effects in the following 24 h were mild and included dizziness, irritability, and vomiting.Conclusions:Oral triclofos was found to be an effective sedative for EEG in children with minimal adverse effects.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of oral triclofos as sedative for children undergoing sleep electroencephalogram: An observational study

Jain

Sharma

et al. 2016

J Pediatr Neurosci

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“…The initial sedation dose of chloral hydrate used in the studies ranged from 25 mg/kg to 100 mg/kg oral and 50 mg/kg rectal. The type and doses of the sedation agents used varied among the included studies: oral dexmedetomidine 2 or 3 mg/kg (Gumus 2015); intravenous pentobarbital 5 mg/kg (Malviya 2004); midazolam either 0.5 mg/kg orally (Ashrafi 2013;D'Agostino 2000), 0.2 mg/kg intranasally (Fallah 2013), or rectal midazolam 1 mg/ kg (Lopez 1995); oral hydroxyzine hydrochloride 1 mg/kg (Bektas 2014;Sezer 2013); oral promethazine 1 mg/kg (Razieh 2013); and intramuscular atropine/meperidine/promethazine/secobarbital (AMPS) cocktail 0.08 mL/kg (Thompson 1982). Two stud-ies compared sedation of high-dose (100 mg/kg) chloral hydrate versus low-dose (50 mg/kg or 70 mg/kg) chloral hydrate orally (Gumus 2015;.…”

Section: Included Studiesmentioning

confidence: 99%

“…Risk of bias in the included studies varied widely. There was at least one high-risk domain in eight out of the 13 included studies (Ashrafi 2010;Ashrafi 2013;Bektas 2014;Gumus 2015;Lopez 1995;Malviya 2004;Thompson 1982). We judged all of these eight studies to be at high risk for blinding of participants, except Bektas 2014, which we judged to be at unclear risk.…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

Chloral hydrate as a sedating agent for neurodiagnostic procedures in children

Fong

Tay

Ong

et al. 2017

Cochrane Database of Systematic Reviews

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The quality of evidence for the comparisons of oral chloral hydrate against several other methods of sedation was very variable. Oral chloral hydrate appears to have a lower sedation failure rate when compared with oral promethazine for children undergoing paediatric neurodiagnostic procedures. The sedation failure was similar for other comparisons such as oral dexmedetomidine, oral hydroxyzine hydrochloride, and oral midazolam. When compared with intravenous pentobarbital and music therapy, oral chloral hydrate had a higher sedation failure rate. However, it must be noted that the evidence for the outcomes for the comparisons of oral chloral hydrate against intravenous pentobarbital and music therapy was of very low to low quality, therefore the corresponding findings should be interpreted with caution.Further research should determine the effects of oral chloral hydrate on major clinical outcomes such as successful completion of procedures, requirements for additional sedative agent, and degree of sedation measured using validated scales, which were rarely assessed in the studies included in this review. The safety profile of chloral hydrate should be studied further, especially the risk of major adverse effects such as bradycardia, hypotension, and oxygen desaturation.

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“…At low doses, it increases the number of b waves and decreases the y and a waves. 11 Hydroxyzine has efficacy similar to CH, 7,8 but its effects on the EEG have not been completely described. 10 Inhalational anesthetics such as sevoflurane might induce epileptiform electroencephalographic activity.…”

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confidence: 99%

“…10 At higher doses, the number of b waves decreases and d waves appear. 7,8 Dexmedetomidine (DEX), a highly selective agonist of the a2-adrenergic receptor, has been highlighted in this scenario because it does not appear to interfere with the EEG in adults or children. 11 Hydroxyzine has efficacy similar to CH, 7,8 but its effects on the EEG have not been completely described.…”

mentioning

confidence: 99%