title: Chloral hydrate sedation in radiology: retrospective audit of reduced dose.
abstract: BACKGROUND
  Chloral hydrate (CH) is safe and effective for sedation of suitable children.
  
  
  OBJECTIVE
  The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses.
  
  
  METHODS
  We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose.
  
  
  RESULTS
  In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P < 0.001). Sedation was successful in 96.7%, and more frequently successful in infants (98.3%) than children >1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen.
  
  
  CONCLUSIONS
  We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival.
authors.affiliation: Radiology Department, Children's University Hospital, Temple Street, Dublin, Ireland. jenny_bracken@hotmail.com
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bracken
authors.forename: Ingrid
authors.initials: I
authors.lastname: Heaslip
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods* / Q000706:statistics & numerical data*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007223:Infant; D007231:Infant, Newborn; D007494:Ireland / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit
chemical_list: D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate