title: Use of chloral hydrate as a sedative for auditory brainstem response testing in a pediatric population.
abstract: OBJECTIVE
  Chloral hydrate (CH) is an oral sedative widely used to sedate infants and young children during auditory brainstem response (ABR) testing. The aim of this study was to record effectiveness, complications and safety of CH as a sedative for ABR.
  
  
  METHODS
  From January of 2003 until December of 2007, 1903 children were tested for ABR, 568 of them being under the age of 6 months. CH (8%) was used for sedation at a dose of 40 mg/kg with a repeat dose, if necessary, for an adequate sedation, in 20-30 min. We recorded the effectiveness of CH as a sedative for ABR examination, as well as all complications related to the use of CH such as vomiting, rash, hyperactivity, respiratory distress and apnea. The statistical method used was the absolute and percentage frequency distribution of the occurrences.
  
  
  RESULTS
  Sedation with CH was necessary to perform testing in 1591 (83.6%) of the examined children. However, in the population of the examined infants, only 341 (60%) were sedated with CH, because the remaining 227 (40%) fell asleep by themselves. Complications included hyperactivity in 152 children (8%), minor respiratory distress in 10 children (0.4%), vomiting in 217 children (11.4%), apnea in 4 children (0.2%) and rash in 10 children (0.4%). The complications of hyperactivity, vomiting and rash resolved without any medical treatment. The apnea cases were managed effectively by supplying ventilation to the children via a mask in the presence of an anesthesiologist.
  
  
  CONCLUSIONS
  The use of CH at a dose of 40 mg/kg up to 80 mg/kg is safe and effective when administered in a setting with adequate equipment and the presence of well trained personnel.
authors.affiliation: ENT Department of Pediatric Hospital Aglaia Kyriakou, Thivon & Levadias Street, GR-11527, Athens, Greece. eavlonitou@hotmail.com
authors.forename: Eirini
authors.initials: E
authors.lastname: Avlonitou
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Balatsouras
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Margaritis
authors.forename: Polyvios
authors.initials: P
authors.lastname: Giannakopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Douniadakis
authors.forename: Michael
authors.initials: M
authors.lastname: Tsakanikos
mesh_terms: D000293:Adolescent; D001300:Audiometry, Evoked Response; D002648:Child; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000627:therapeutic use*; D015331:Cohort Studies; D016292:Procedural Sedation; D004305:Dose-Response Relationship, Drug; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate