The use of oral pentobarbital sodium (Nembutal) versus oral chloral hydrate in infants undergoing CT and MR imaging - a pilot study

Background. Chloral hydrate, a commonly used oral sedative for infants unde rgoing imaging examinations. has a bitter taste and requires relatively lar ge volume, provoking unpleasant reactions from the infants. Experience with an alternative sedative, oral pentobarbital (Nembutal), has not been repor ted for infants. Objective. To compare patient acceptance of oral Nembutal and oral chloral hydrate for sedation of infants up to 12 months of age. Methods and materials. Fifty-four infants (mean age: 7 months) were prospec tively enrolled. Parents chose Nembutal, chloral hydrate, or no preference. Thirty-eight infants received Nembutal (4-6 mg/kg) mixed with cherry syrup and 16 received chloral hydrate (50-100 mg/ kg). We recorded infant's acce ptance of sedative, parental impression of infant's acceptance, time to sed ation, time to discharge, adverse effects, parental preference of future se dative. Results. Infant acceptance and parental impression were better for Nembutal (P < 0.0001). Fewer parents in the Nembutal group preferred another sedati ve (P = 0.05). There was a trend toward shorter time to discharge with Nemb utal (P = 0.03), There were no adverse effects in either group. One infant failed to sedate with Nembutal. Conclusions. Compared with chloral hydrate, oral Nembutal has significantly better acceptance by infants and parents, equal effectiveness, and may res ult in a shorter time to discharge.