Psychological and behavioral effects of chloral hydrate in day-case pediatric surgery: a randomized, observer-blinded study.
OBJECTIVE
This prospective, randomized, and observer-blinded study was performed to evaluate the effects of oral chloral hydrate on perioperative psychological and behavioral phenomena in children.


METHODS
In total, 100 boys (age, 1-5 years) scheduled for day-case unilateral orchiopexy were randomly allocated into 2 groups and orally administered either 40 mg/kg of chloral hydrate (CH group) or placebo (control group) 30 minutes before surgery, followed by assessment of anxiety, induction compliance, emergence delirium, postoperative pain, and maladaptive behavioral changes.


RESULTS
Anxiety scores were significantly lower in the CH group compared with the control group (45.7 vs 28.8). The induction compliance of the CH group was better than that of the control group (3.2 vs 4.8). Postoperative sedation was more frequent (62.7% vs 20.4%); however, the incidence of vomiting was lower (2.0% vs 14.3%) in the CH group than in the control group. Postoperative emergence delirium and maladaptive behavior changes were similar between the 2 groups.


CONCLUSIONS
Decreasing preoperative anxiety with oral chloral hydrate improves induction compliance and reduces postoperative pain intensity without delaying recovery in young boys. However, chloral hydrate had little impact on emergence delirium and postoperative maladaptive behavior.
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. hkkil@yuhs.ac
Hae K
HK
Kil
Won O
WO
Kim
Sang W
SW
Han
Youngjun
Y
Kwon
Aerina
A
Lee
Jeong-Yeon
JY
Hong
D000556:Ambulatory Surgical Procedures; D018681:Anesthetics, General / Q000009:adverse effects; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology / Q000517:prevention & control; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D007223:Infant; D008297:Male; D056126:Orchiopexy; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D010349:Patient Compliance; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000517:prevention & control; D016037:Single-Blind Method
D018681:Anesthetics, General; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate