Kl. Napoli et al., SAFETY AND EFFICACY OF CHLORAL HYDRATE SEDATION IN CHILDREN UNDERGOING ECHOCARDIOGRAPHY, The Journal of pediatrics, 129(2), 1996, pp. 287-291
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.