title: Chloral hydrate for sedation of children with asthma during dental treatment.
abstract: OBJECTIVE
  We hypothesised that chloral hydrate is safe and effective for sedation during dental treatments for children with mild asthma. We evaluated the safety and efficacy of chloral hydrate by measuring changes in heart rate (HR), transcutaneous oxygen saturation, (SpO2), asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment.
  
  
  METHODS
  Children (<10 years old) with mild asthma undergoing dental treatments received a single 65 mg/kg oral dose of chloral hydrate liquid 1 hour prior to treatment in an open label trial. Heart rate (HR), SpO2, asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment. Asthma score was obtained before and after treatment. Thirty minutes after treatment, SpO2, HR, and level of consciousness was assessed.
  
  
  RESULTS
  Twenty four children were enrolled and 92% (22/24) recovered from sedation without respiratory depression. Two experienced mild respiratory depression related to chloral hydrate. Asthma was not a contributing factor as they did not experience wheezing, cough, tachypnoea, or retractions. Inhaled nitrous oxide supplemented chloral hydrate sedation in 63% (15/24) children to achieve effective cooperation. Three children had a SpO2 <95% (2 during treatment, 1 during recovery).
  
  
  CONCLUSIONS
  Chloral hydrate 65 mg/kg administered a as single oral dose appears to be safe with respect to disease exacerbation for children with mild asthma undergoing dental treatment. Due to ineffective sedation and mild respiratory depression associated with chloral hydrate, newer, easily titrated medications, such as midazolam, may offer advantages.
authors.affiliation: Department of Developmental Dentistry, Children's Hospital of Michigan, Wayne State University, Detroit, USA.
authors.forename: I
authors.initials: I
authors.lastname: Abdulhamid
authors.affiliation: Pulmonary Medicine Division and Pediatric Sleep Laboratory, Wayne State University, Detroit, USA.
authors.forename: M
authors.initials: M
authors.lastname: Tremblay
authors.affiliation: Pulmonary Medicine Division and Pediatric Sleep Laboratory, Wayne State University, Detroit, USA.
authors.forename: J
authors.initials: J
authors.lastname: Stenger
authors.affiliation: The Eugene Applebaum College of Pharmacy and Health Sciences, Department of Pharmacy Practice.
authors.forename: V
authors.initials: V
authors.lastname: Tutag Lehr
mesh_terms: D001249:Asthma; D002648:Child; D002697:Chloral Hydrate / Q000008:administration & dosage*; D003752:Dental Health Services; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*
chemical_list: D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate