A comparison of the efficacy and safety of chloral hydrate versus inhaled anesthesia for sedating infants and toddlers for transthoracic echocardiograms.
BACKGROUND
Pediatric patients may need sedation for a transthoracic echocardiogram. Due to the unpredictability and safety concerns with chloral hydrate, we offered mask anesthesia as an alternate strategy.


METHODS
A retrospective chart review of 507 pediatric patients sedated for transthoracic echocardiography was conducted to compare the use of oral chloral hydrate (n = 297) with the face mask administration of sevoflurane anesthesia (n = 210).


RESULTS
Anesthesia had a shorter time from administration of sedation to hospital discharge (112 vs 155 minutes), largely because of a shorter, more predictable, and less variable time to achieve satisfactory study conditions. Using anesthesia, an average 43-minute difference would allow for an additional procedure using the same resources. Anesthesia was not associated with sedation failure (0% vs 6%), and the duration of examination was shorter (40 vs 46 minutes). There were no significant adverse events in either cohort.


CONCLUSIONS
Anesthesia, although more costly, is balanced by more the efficient use of hospital and parental resources, with greater family and staff satisfaction.
Nicolson
Susan C
SC
Division of Cardiothoracic Anesthesia, The Cardiac Center at The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-4399, USA. nicolson@email.chop.edu
Montenegro
Lisa M
LM
Cohen
Meryl S
MS
O'Neill
Daniel
D
Calfin
Donna
D
Jones
Lisa A
LA
Jobes
David R
DR
D000280:Administration, Inhalation; D000284:Administration, Oral; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage*; D015897:Comorbidity; D016292:Procedural Sedation / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D004452:Echocardiography / Q000187:drug effects* / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D010424:Pentobarbital / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity
D018685:Anesthetics, Inhalation; D002697:Chloral Hydrate; D010424:Pentobarbital