Chloral hydrate, chloral hydrate--promethazine and chloral hydrate -hydroxyzine efficacy in electroencephalography sedation.
OBJECTIVE
To compare efficacy and safety of chloral hydrate (CH), chloral hydrate and promethazine (CH + P) and chloral hydrate and hydroxyzine (CH + H) in electroencephalography (EEG) sedation.


METHODS
In a parallel single-blinded randomized clinical trial, ninety 1-7 y-old uncooperative kids who were referred to Pediatric Neurology Clinic of Shahid Sadoughi University, Yazd, Iran from April through August 2012, were randomly assigned to receive 40 mg/kg of chloral hydrate or 40 mg/kg of chloral hydrate and 1 mg/kg of promethazine or 40 mg/kg of chloral hydrate and 2 mg/kg of hydroxyzine. The primary endpoint was efficacy in sufficient sedation (obtaining four Ramsay sedation score) and successful completion of EEG. Secondary endpoint was clinical adverse events.


RESULTS
Thirty nine girls (43.3 %) and 51 boys (56.7 %) with mean age of 3.34 ± 1.47 y were assessed. Sufficient sedation and completion of EEG were achieved in 70 % (N = 21) of chloral hydrate group, in 83.3 % (N = 25) of CH + H group and in 96.7 % (N = 29) of CH + P group (p = 0.02). Mild clinical adverse events including vomiting [16.7 % (N = 5) in CH, 6.7 % (N = 2) in CH + P, 6.7 % (N = 2) in CH + H], agitation in 3.3 % of CH + P (N = 1) group and mild transient hypotension in 3.3 % of CH + H (N = 1) group occurred. Safety of these three sedation regimens was not statistically significant different (p = 0.14).


CONCLUSIONS
Combination of chloral hydrate-antihistamines can be used as the most effective and safe sedation regimen in drug induced sleep electroencephalography of kids.
Department of Pediatrics, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Razieh
R
Fallah
Ali
A
Alaei
Sedighah
S
Akhavan Karbasi
Ahmad
A
Shajari
D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage*; D016292:Procedural Sedation; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage*; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D011398:Promethazine / Q000008:administration & dosage*; D016037:Single-Blind Method; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D006919:Hydroxyzine; D002697:Chloral Hydrate; D011398:Promethazine