title: Efficacy of chloral hydrate-hydroxyzine and chloral hydrate-midazolam in pediatric magnetic resonance imaging sedation.
abstract: OBJECTIVE
  Magnetic resonance imaging (MRI) is a useful diagnostic tool for the evaluation of congenital or acquired brain lesions. But, in all of less than 8-year-old children, pharmacological agents and procedural sedation should be used to induce motionless conditions for imaging studies. The purpose of this study was to compare the efficacy and safety of combination of chloral hydrate-hydroxyzine (CH+H) and chloral hydrate-midazolam (CH+M) in pediatric MRI sedation.
  
  
  METHODS
  In a parallel single-blinded randomized clinical trial, sixty 1-7-year-old children who underwent brain MRI, were randomly assigned to receive chloral hydrate in a minimum dosage of 40 mg/kg in combination with either 2 mg/kg of hydroxyzine or 0.5 mg/kg of midazolam. The primary outcomes were efficacy of adequate sedation (Ramsay sedation score of five) and completion of MRI examination. The secondary outcome was clinical side-effects.
  
  
  RESULTS
  Twenty-eight girls (46.7%) and 32 boys (53.3%) with the mean age of 2.72±1.58 years were studied. Adequate sedation and completion of MRI were achieved in 76.7% of CH+H group. Mild and transient clinical side-effects, such as vomiting of one child in each group and agitation in 2 (6.6 %) children of CH+M group, were also seen. The adverse events were more frequent in CH+M group.
  
  
  CONCLUSIONS
  Combinations of chloral hydrate-hydroxyzine and chloral hydrate-midazolam were effective in pediatric MRI sedation; however, chloral hydrate-hydroxyzine was safer.
authors.affiliation: Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences,Yazd, Iran ; Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Fallah
authors.affiliation: Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Fadavi
authors.affiliation: Department of Anesthesia and Intensive Care, Shahid Sadoughi University of Medical Sciences,Yazd, Iran.
authors.forename: Shekofah
authors.initials: S
authors.lastname: Behdad
authors.affiliation: Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Fallah Tafti
keywords: Children; Hydroxyzine; MRI; Midazolam.; Sedation; chloral hydrate