title: Efficacy of Chloral Hydrate and Promethazine for Sedation during Electroencephalography in Children; a Randomised Clinical Trial.
abstract: OBJECTIVE
  The purpose of this study was to compare efficacy and safety of oral chloral hydrate (CH) and promethazine (PZ) for sedation during electroencephalography (EEG) in children.
  
  
  METHODS
  In a parallel single-blinded randomized clinical trial, sixty 1-10 year old children referred to EEG Unit of Shahid Sadoughi Hospital from January 2010 to February 2011 in Yazd, Iran, were evaluated. They were randomized to receive orally 70 mg/kg chloral hydrate or promethazine 1 mg/kg. The primary outcome was efficacy in adequate sedation and successful recording of EEG. Secondary outcome included clinical side effects, time from administration of the drug to adequate sedation, caregiver's satisfaction on a Likert scale, and total stay time in EEG Unit.
  
  
  RESULTS
  Twenty four cases with mean age 2.9±1.9 years were evaluated. Adequate sedation (Ramsay sedation score of four) was obtained in 43.3% of PZ and 100% of CH group (P=0.00001). Also in 70% of PZ and 96.7% of CH group, EEG was successfully recorded (P=0.006). So, CH was a more effective drug. In CH group, EEG was performed in shorter time after taking the drug (32.82±9.6 vs 52.14±22.88 minutes, P<0.001) and the parents waited less in the EEG unit (1.29±0.54 vs 2.6±0.59 hours, P<0.001). They were also more satisfied (4.6±0.6 scores vs 3.1±1.4 scores, P=0.001). Mild side effects such as vomiting in 20% of CH (n = 6) and agitation in 6.6% of PZ group (n = 2) were seen. No significant difference was seen from viewpoint of side effects frequency between the two drugs.
  
  
  CONCLUSIONS
  The results of the present study showed that chloral hydrate can be considered as a safe and more effective drug in sedation induction for sleep EEG in children.
authors.affiliation: Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Fallah
authors.initials: F
authors.lastname: Razieh
authors.forename: Jalili
authors.initials: J
authors.lastname: Sharam
authors.forename: Golestan
authors.initials: G
authors.lastname: Motahhareh
authors.forename: Akhavan Karbasi
authors.initials: AK
authors.lastname: Sedighah
authors.forename: Jarahzadeh
authors.initials: J
authors.lastname: Mohammad-Hosein
keywords: Chloral hydrate; EEG; Promethazine; Sedation
references.citation: Pediatr Emerg Care. 2000 Feb;16(1):1-4
references.pmid: 10698133
references.citation: Anesth Prog. 2002 Winter;49(1):14-8
references.pmid: 12779109
references.citation: Pediatrics. 2006 Mar;117(3):e434-41
references.pmid: 16481449
references.citation: Int J Pediatr Otorhinolaryngol. 2011 Jun;75(6):760-3
references.pmid: 21531030
references.citation: Braz Dent J. 2007;18(4):334-40
references.pmid: 18278305
references.citation: Pediatrics. 2006 Dec;118(6):2587-602
references.pmid: 17142550
references.citation: J Emerg Med. 2010 Sep;39(3):330-6
references.pmid: 20022195
references.citation: Paediatr Anaesth. 2007 Jul;17(7):630-6
references.pmid: 17564644
references.citation: Drug Saf. 2006;29(1):67-77
references.pmid: 16454535
references.citation: Br Med J. 1974 Jun 22;2(5920):656-9
references.pmid: 4835444
references.citation: Methods Find Exp Clin Pharmacol. 2000 Apr;22(3):163-8
references.pmid: 10893699
references.citation: West Afr J Med. 1998 Oct-Dec;17(4):224-6
references.pmid: 9921085
references.citation: Pediatr Dent. 2001 Sep-Oct;23(5):424-30
references.pmid: 11699169
references.citation: Singapore Med J. 1996 Apr;37(2):139-42
references.pmid: 8942248
references.citation: Indian J Pediatr. 2001 Apr;68(4):319-22
references.pmid: 11370437
references.citation: J Clin Pediatr Dent. 2009 Winter;34(2):183-8
references.pmid: 20297714
references.citation: Ir Med J. 2008 Mar;101(3):80-2
references.pmid: 18540545
references.citation: Curr Opin Pediatr. 2012 Apr;24(2):225-32
references.pmid: 22245909
references.citation: J Clin Pharm Ther. 1994 Aug;19(4):239-43
references.pmid: 7989402
references.citation: Braz J Otorhinolaryngol. 2010 Jul-Aug;76(4):433-6
references.pmid: 20835528
references.citation: J Clin Pediatr Dent. 2002 Winter;26(2):161-4
references.pmid: 11874008
references.citation: Saudi Med J. 2005 May;26(5):746-9
references.pmid: 15951862
references.citation: Pediatr Cardiol. 2010 May;31(4):469-73
references.pmid: 20047024