title: Clinical sedation and bispectral index in burn children receiving gamma-hydroxybutyrate.
abstract: BACKGROUND
  Gamma-hydroxybutyrate (GHB) may be an interesting hypnotic agent in burn patients because of its good respiratory or hemodynamic tolerance. However, its clinical and electroencephalographic (EEG) sedative effects are not yet described in children. The aim of this prospective and randomized study was to assess clinical and EEG effects of increasing intravenous (IV) doses of GHB in burn children requiring sedation for burn wound cares.
  
  
  METHODS
  Thirty six children hospitalized in a burn care unit were included and randomly assigned into three groups (G) according to the single IV dose of GHB they received before burn wound care: 10 mg · kg(-1) in G10, 25 mg · kg(-1) in G25, or 50 mg · kg(-1) in G50. All patients received oral premedication (morphine and hydroxyzine) 30 min before GHB injection. Respiratory rate, heart rate, pulse oximetry, and bispectral index (BIS) were continuously monitored. Depth of sedation was clinically assessed using Observer's Assessment of Alertness and Sedation (OAAS) Score, every 2 min until recovery (i.e., OAAS = 4).
  
  
  RESULTS
  Median age was 17.5 [12-34] months. Whatever the dose, BIS decreased after IV GHB. Nadir value of BIS was significantly lower in G25 and G50 than in G10, as was for OAAS score. Nadir values were reached after same delays in G25 and G50. Duration of sedation was dose-dependent.
  
  
  CONCLUSIONS
  Bispectral index decreased after GHB injection and was correlated with OAAS score. Deep sedation can be safely achieved with IV doses of 25 or 50 mg · kg(-1), but the last dose was associated with prolonged duration of clinical sedation.
authors.affiliation: Intensive Care Department and Burn Centre, University Hospital, Liège, Belgium. afrousseau@chu.ulg.ac.be
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Rousseau
authors.forename: Didier
authors.initials: D
authors.lastname: Ledoux
authors.forename: Nada
authors.initials: N
authors.lastname: Sabourdin
authors.forename: Patrick
authors.initials: P
authors.lastname: Richard
authors.forename: Pierre
authors.initials: P
authors.lastname: Damas
authors.forename: Isabelle
authors.initials: I
authors.lastname: Constant
mesh_terms: D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D056805:Consciousness Monitors; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D010100:Oxygen / Q000097:blood; D059408:Pain Management; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology; D011446:Prospective Studies; D056152:Respiratory Rate / Q000502:physiology; D012978:Sodium Oxybate / Q000008:administration & dosage
chemical_list: D006993:Hypnotics and Sedatives; D012978:Sodium Oxybate; D010100:Oxygen; D015742:Propofol