title: Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children.
abstract: Sedation of children for electroencephalography (EEG) recordings is often required. Chloral hydrate (CH) requires medical clearance and continuous monitoring. To try to reduce personnel and time resources associated with CH administration, a new sedation policy was formulated. This study included all children who underwent an EEG during a consecutive 3-month period following the implementation of the new sedation policy, which consists of the sequential administration of melatonin, hydroxyzine (if needed), and CH (if needed). The comparator group included all children with a recorded EEG during a consecutive 3-month period when the sedation policy consisted of the sole administration of CH. A total of 803 children with a mean age of 7.9 years (SD = 5.1, range = 0.5-17.7 years) were included. Sleep EEG recordings were obtained in 364 of 385 children (94.6%) using the old sedation policy and in 409 of 418 children (97.9%) using the new one. With the new sedation policy, the percentage of children requiring CH dropped from 37.1% to 6.7% (P < .001). Time to sleep onset and duration of sleep were not significantly different between the 2 policies. The new sedation policy was very well tolerated. The new sedation policy is very safe, is highly efficacious in obtaining sleep EEG recordings, and will result in substantial saving of time and personnel resources.
authors.affiliation: Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Maya
authors.initials: M
authors.lastname: Dirani
authors.affiliation: Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Wassim
authors.initials: W
authors.lastname: Nasreddine
authors.affiliation: Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Jawad
authors.initials: J
authors.lastname: Melhem
authors.affiliation: Ibn Sina Hospital, Kuwait City, Kuwait.
authors.forename: Maher
authors.initials: M
authors.lastname: Arabi
authors.affiliation: Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon ab29@aub.edu.lb.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Beydoun
mesh_terms: D002492:Central Nervous System Depressants; D002648:Child; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D004569:Electroencephalography / Q000187:drug effects* / Q000379:methods; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage*; D006993:Hypnotics and Sedatives; D007223:Infant; D008297:Male; D008550:Melatonin / Q000008:administration & dosage*; D017286:Polysomnography / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012890:Sleep / Q000187:drug effects* / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D006919:Hydroxyzine; D002697:Chloral Hydrate; D008550:Melatonin
keywords: EEG; chloral hydrate; hydroxyzine; melatonin; sedation