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Chloral Hydrate, Chloral Hydrate - Promethazine and Chloral Hydrate -Hydroxyzine Efficacy in Electroencephalography Sedation

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Abstract

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.

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Acknowledgments

The authors thank Professor Nasrollah Bashardoost for data analyzing help.

Contributions

RF: Writing the manuscript; AA and AS: Gathering the data; SAK: Editing the manuscript. RF will act as guarantor for this paper.

Conflict of Interest

None.

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None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Razieh Fallah & Sedighah Akhavan Karbasi

  2. Ali-ebn-Abitaleb School of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran

    Ali Alaei

  3. Department of Pediatrics, Ali-ebn-Abitaleb School of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran

    Ahmad Shajari

  4. Shahid Sadoughi Hospital, Ave - Sina Blvd, Shahid Ghandi Blvd, Yazd, Islamic Republic of Iran

    Sedighah Akhavan Karbasi

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  1. Razieh Fallah
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Corresponding author

Correspondence to Sedighah Akhavan Karbasi.

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Fallah, R., Alaei, A., Akhavan Karbasi, S. et al. Chloral Hydrate, Chloral Hydrate - Promethazine and Chloral Hydrate -Hydroxyzine Efficacy in Electroencephalography Sedation. Indian J Pediatr 81, 541–546 (2014). https://doi.org/10.1007/s12098-013-1298-y

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  • DOI: https://doi.org/10.1007/s12098-013-1298-y

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