SAFETY AND EFFICACY OF CHLORAL HYDRATE SEDATION IN CHILDREN UNDERGOING ECHOCARDIOGRAPHY

The purpose of this prospective study was to determine the safety and efficacy of chloral hydrate sedation in children with known or suspect ed congenital heart disease. The study population included 405 childre n with a median age of 13 months (3 weeks to 14 years). Cyanotic heart disease was present in 64 of the children, The median dosage of chlor al hydrate given was 77 mg/kg, with a range of 25 to 125 mg/kg. Sedati on was achieved in 397 (98%) of the children. The complete study time averaged 2.2 hours (range, 1.6 to 5.2 hours), The time to achieve seda tion was 30 minutes or less in 82%, more than 30 but less than 60 minu tes in 12%, and more than 60 minutes in 4%; 2% failed to achieve sedat ion, Children aged 3 years or younger were more likely to be successfu lly sedated with chloral hydrate (p = 0.003). The type of heart diseas e did not affect the success of sedation. No child had a clinically si gnificant change in heart rate or blood pressure during sedation; howe ver, oxygen saturation decreased in 24 (6%) of 397 children successful ly sedated, Decreases in oxygen saturation occurred more commonly in c hildren with trisomy 21 (7/13) than in children without genetic syndro mes (17/384), Vomiting occurred in 23 (6%) of the 405 study subjects, usually immediately after drug administration, Chloral hydrate is a sa fe and effective agent for sedation of children with known or suspecte d congenital heart disease who are undergoing echocardiography in the outpatient cardiology clinic.