Adverse events and outcomes of conscious sedation for pediatric patients -Study of an oral sedation regimen

Background. The authors report on adverse events and sedation outcomes for an oral sedation regimen of chloral hydrate, meperidine and hydroxyzine wit h 100. percent oxygen, or O-2 supplementation. Methods. In a five-year retrospective study, the authors examined 195 recor ds of conscious sedation performed in 111 healthy children aged 24 to 48 mo nths (mean, 47 months). The authors analyzed age, sex, weight, methods of d rug delivery, waiting time after drug administration, treatment rendered, t reatment time, adverse events, sedation outcomes and the number of visits n eeded to complete treatment using descriptive statistics, chi (2) tests, t test and analysis of variance. Results. Adverse events-including vomiting desaturation, prolonged sedation and an apneic event-occurred in 3 percent of all sedations and were minor. Seventy-two percent of sedations had satisfactory behavioral outcomes, 23 percent had unsatisfactory outcomes, and 5 percent of the cases were aborte d because of disruptive behavior. Sex was not a significant factor or the s uccess. Patient compliance with drinking medications (P = .013) and a longe r waiting time after medication intake (P = .012) yielded better sedation o utcomes. Conclusions. Minimal minor adverse events occurred with this sedation regim en. The success rate was 72 percent. Compliance with taking oral medication s and waiting time appeared to be important factors in predicting sedation success. Clinical Implications. This oral sedation regimen offers reasonable outcome s with minimal adverse events under a strict Protocol, and use of O-2 suppl ementation. The results also revealed associations that give guidance for c ase selection and outcome prediction.