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Chloral hydrate and/or hydroxyzine for sedation in pediatric EEG recording

      Abstract

      Purpose: To evaluate and compare the success of chloral hydrate (CH) and hydroxyzine on sedation and assess the changes of these drugs on sleep EEG recordings. Method: Three hundred and forty-one patients (mean age: 60.92 ± 53.81 months) that were uncooperative with the EEG setup or referred for sleep EEG were enrolled in the study. Patients, partially sleep-deprived the night before, were firstly tried to fall on sleep without any medication, the patients who could not sleep spontaneously were randomly divided in two groups of hydroxyzine and chloral hydrate. Results: In 147 (43%) of cases, CH was given for sedation. In 112 (32%) hydroxyzine and in 8% of cases CH and hydroxyzine were given. 17% of children had spontaneous sleep. The doses of drugs prescribed were as follows: hydroxyzine 1.43 ± 0.74 mg/kg CH 38 ± 14.73 mg/kg. The time to go on a sleep was 34.68 ± 30.75 min in hydroxyzine and 32.34 ± 26.83 min in CH group (p > 0.05). Eighty-nine percent of cases who were sedated with CH and 89.6% of cases who sedated with hydroxyzine were able to sleep (p > 0.05). The background rhythm was faster with CH compared to hydroxyzine (p< 0.05). There were no association between the occurrence of fast background rhythm and the doses of CH. Conclusion: The study described the clinical practice of sedation with CH and hydroxyzine on EEG recording. Data suggest that CH with low doses and hydroxyzine is equally effective for sleep induction, but the side effects of CH on the sleep EEG is much more prominent.

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      References

        • Thoresen M.
        • Henriksen O.
        • Wannag E.
        • Laegreid L.
        Does a sedative dose of chloral hydrate modify the EEG of children with epilepsy?.
        Electroencephalogr Clin Neurophysiol. 1997; 102: 152-157
        • Olson D.M.
        • Sheehan M.G.
        • Thompson W.
        • Hall P.T.
        • Hahn J.
        Sedation of children for electroencephalograms.
        Pediatrics. 2001; 108: 163-165
        • Heistein L.C.
        • Ramaciotti C.
        • Scott W.A.
        • Coursey M.
        • Sheeran P.W.
        • Lemler M.S.
        Chloral hydrate sedation for pediatric echocardiography: physiologic responses, adverse events, and risk factors.
        Pediatrics. 2006; 117: 434-441
        • Malviya S.
        • Voepel-Lewis T.
        • Prochaska G.
        • Tait A.R.
        Prolonged recovery and delayed side effects of sedation for diagnostic imaging studies in children.
        Pediatrics. 2000; 105: E42
      1. Stracciolini A, Chloral hydrate. In: McGuigan M, Anderson A, Woolf A, editors. Clinical toxicology review. Massachusetts:Rhode Island Poison Control System; 1998. p. 21.

        • Gauillarad J.
        • Cheref S.
        • Vacherontrystram M.N.
        • Martin J.C.
        Chloral hydrate: a hypnotic best forgotten?.
        Encephale. 2002; 28: 200-204
        • Greenberg S.B.
        • Faerber E.N.
        • Aspinall C.L.
        High dose chloral hydrate sedation for children undergoing MR imaging: safety and efficacy in relation to age.
        AJR Am J Roentgenol. 1993; 161: 639-641
        • Pershad J.
        • Palmisano P.
        • Nichols M.
        Chloral hydrate: the good and the bad.
        Pediatr Emerg Care. 1999; 15: 432-435
        • Khoo G.P.
        • Bolton O.
        Neonatal and paediatric intensive care.
        Hospital Pharm. 2003; 10: 66-70
        • Taketomo C.K.
        • Hodding J.H.
        • Kraus D.M.
        Pediatric dosage handbook.
        12th ed. Lexi-Comp, Hudson, OH2006
        • Nahata M.C.
        Sedation in pediatric patients undergoing diagnostic procedures.
        Drug Intell Clin Pharm. 1988; 22: 711-715
        • Lasagna L.
        Hypnotic drugs.
        N Engl J Med. 1972; 7: 1182-1184
        • Castro C.B.
        • Chisté M.A.
        • Vizioli J.F.
        • Córdova N.M.
        • Ohlweiler L.
        • Lago I.S.
        • et al.
        Comparison between the EEG of natural sleep and the induced by chloral hydrate in relation to paroxysmal changes and baseline rhythm.
        Arq Neuropsiquiatr. 1994; 52: 326-329
        • Babe K.S.
        • Serafin W.E.
        Histamine, bradykinin, and their antagonists.
        in: Hardman J.G. Limbird L.E. Molinoff P.B. Ruddon R.W. Goodman-Gilman A. Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. McGraw-Hill, 1996: 581-600 (International edition)
        • Moore P.A.
        Therapeutic assessment of chloral hydrate premedication for pediatric dentistry.
        Oral Health. 1985; 75: 13-16
        • Nathan J.E.
        Management of the refractory young child with chloral hydrate: dosage selection.
        J Dent Child. 1987; 54: 22-29
        • Hasty M.F.
        • Vann W.F.
        • Dilley D.C.
        • Anderson J.A.
        Conscious sedation of pediatric dental patients: An investigation of chloral hydrate, hydroxyzine pamoate and meperidine vs. chloral hydrate and hydroxyzine pamoate.
        Pediatr Dent. 1991; 13: 10-19
        • Pechadre J.C.
        • Beudin P.
        • Trolese J.F.
        • Gabet J.Y.
        • Eschalier A.
        A comparison of the electroencephalographic spectral modifications induced by diazepam and by hydroxyzine.
        J Int Med Res. 1993; 21: 234-242
        • Rumm P.D.
        • Takao R.T.
        • Fox D.J.
        • Atkinson S.W.
        Efficacy of sedation of children with chloral hydrate.
        South Med J. 1990; 83: 1040-1042
        • Britton J.W.
        • Kosa S.C.
        The clinical value of chloral hydrate in routine electroencephalogram.
        Epilepsy Res. 2010; 88: 215-220
        • Krsek P.
        • Sebronova V.
        • Prochazka T.
        • Maulisova A.
        • Komarek V.
        Successful treatment of Ohtahara syndrome with chloral hydrate.
        Pediatr Neurol. 2002; 27: 388-391
        • Lampl Y.
        • Eshel Y.
        • Gilad R.
        • Sarova-Pinchas I.
        Chloralhydrate in intractable status epilepticus.
        Ann Emerg Med. 1990; 19: 674-676
        • Rowan A.J.
        • Veldhuisen R.J.
        • Nagelkerke N.J.
        Comparative evaluation of sleep deprivation and sedated sleep EEGs as diagnostic aids in epilepsy.
        Electroencephalogr Clin Neurophysiol. 1982; 54: 357-364
        • Jan M.M.S.
        • Aquino M.F.
        The use of chloral hydrate in pediatric electroencephalography.
        Neurosciences. 2001; 6: 99-102