Clonidine Versus Chloral Hydrate for Recording Sleep EEG in Children (original) (raw)
Related papers
International Journal of Epilepsy, 2017
Electroencephalography (EEG) is a valuable tool in the diagnosis of epilepsy. The attainment of a high quality EEG requires patient's co-operation which is particularly difficult in children. Chloral hydrate has been used as a sedating agent in EEGs but it has potential serious adverse effects and anti-epileptic activity. Melatonin is used increasingly in different investigations as a safe alternative. Our study is to compare their effectiveness as sedating agents in performing EEGs and the detection rate of abnormal EEGs. This is a retrospective study performed in a regional hospital in Hong Kong. One hundred and ninety two EEG studies were included from December 2010 to July 2014. One hundred and two children were given chloral hydrate (50 mg/Kg) in the first half of the period and 90 children were given melatonin (3 mg for =< 5 years or 6 mg for >= 5 year) in the later half. The two groups are compared with Pearson's Chi-squared test with Yates’ continuity correctio...
Iranian journal of child neurology, 2013
Electroencephalography (EEG) recording is a long duration procedure that needs patient's cooperation for device setup and performing the procedure. Many children lose their cooperation during this procedure. Therefore, sedation and sleep are frequently induced using a few agents as pre procedure medication in children before EEG recording. We aimed to compare the sedative effects of oral midazolam versus chloral hydrate before the procedure along with their impacts on EEG recording in children. A randomized trial was carried out to compare the sedative effects of oral midazolam versus chloral hydrate and their impacts on EEG recording in children. A total of 198 children (100 in the midazolam group and 98 in the chloral hydrate group) were enrolled in the study and randomly allocated to receive either oral moidazolam or chloral hydrate. Oral midazolam had superiority neither in sleep onset latency nor in sleep duration when compared to chloral hydrate. Moreover, the yield of epi...
Melatonin versus chloral hydrate for recording sleep EEG
European Journal of Paediatric Neurology, 2010
Chloral hydrate Sleep Electroencephalogram a b s t r a c t Although behavioral training could be successful in promoting electroencephalogram (EEG) compliance without restraint or sedation, sleep EEG may increase the yield of seizure activity.
Does a sedative dose of chloral hydrate modify the EEG of children with epilepsy?
Electroencephalography and Clinical Neurophysiology, 1997
Chloral hydrate (CH) is used to sedate children unable to cooperate during investigations such as EEG requiring the patient to be still. It is not known if CH or its metabolites modify the EEG and our aim was to answer this question. Recordings of the EEG before, during and after rectal administration of CH (50-77 mg/kg) in 13 children aged 1.5-13.5 years with severe epilepsy and additional neurological impairments were made. All children had frequent spike-wave activity before CH. In 9 children CH had no effect on the EEG. In 3 children there was a significant reduction in epileptic activity after 20-50 min and in one a significant increase. Cardiovascular parameters were stable throughout. At sedative doses, CH can generally be used before an EEG recording without loss of information but in 4 out of 13 children there were changes which could alter interpretation.
Trials
Background Oral chloral hydrate is widely used in pediatric sedation. Intranasal dexmedetomidine has been increasingly used for pediatric sedation; however, its improvement is warranted. The combination of dexmedetomidine with ketamine can improve onset and hemodynamic stability while maintaining sedative efficacy. This study aims to determine the efficacy and safety of intranasal combination of dexmedetomidine and ketamine compared to oral chloral hydrate. Methods This is a prospective, parallel-arm, single-blinded, two-center, superiority randomized controlled trial with 1:1 allocation, designed to compare the effects of intranasal combination of dexmedetomidine and ketamine with those of oral chloral hydrate. We shall enroll 136 patients aged < 7 years old in this study. Prior to the procedure, we shall randomize each patient into the control group (oral chloral hydrate 50 mg/kg) or study group (intranasal dexmedetomidine 2 μg/kg and ketamine 3 mg/kg). The primary outcome will...
Background Oral chloral hydrate is widely used in pediatric sedation. Intranasal dexmedetomidine has been increasingly used for pediatric sedation; however, its improvement is warranted. The combination of dexmedetomidine with ketamine can improve onset and hemodynamic stability while maintaining sedative efficacy. This study aims to determine the efficacy and safety of intranasal combination of dexmedetomidine and ketamine compared to oral chloral hydrate. Methods This is a prospective, parallel-arm, single-blinded, multi-center, randomized controlled trial with 1:1 allocation, designed to compare the effects of intranasal combination of dexmedetomidine and ketamine with those of oral chloral hydrate. We shall enrol 136 patients aged < 7 years old in this study. Prior to the procedure, we shall randomise each patient into the control group (oral chloral hydrate 50 mg/kg) or study group (intranasal dexmedetomidine 2 µg/kg and ketamine 3 mg/kg). The primary outcome will be the rat...
Clinical Pediatrics, 2006
The prescription rates of clonidine have risen dramatically and the extent to which these increases can be attributed to treatment of sleep disturbance is unknown. Surveys were mailed to 800 pediatricians across four geographically diverse states to assess prescribing practices specific to sleep disturbance. Ninety-six percent of the respondents treated sleep disturbance. More than one third of the sample reported using clonidine specifically for sleep disturbance including sleep onset, sleep schedule, nighttime awakening, and early morning awakening problems and parasomnias. Clonidine ranked second only to antihistamines as the most commonly used medication for treating sleep disturbance. Clin Pediatr. 2006;45:229-238
Chloral Hydrate as a Sedating Agent for Neurodiagnostic Procedures in Children
2018
Neuroimaging and electroencephalography (EEG) are important for the diagnosis, prognosis and development of interventional strategies in paediatric neurodevelopmental disorders. Due to the need of the child to remain still during the imaging exam and sleep EEG, performing these tests is often a challenge. Thus, the use of an adequate sedative agent is paramount for the success of the neurodiagnostic procedures. The National Institute for Health and Care Excellence (NICE) and the American College of Emergency Physicians guidelines recommend chloral hydrate for moderate sedation during painless procedures in children.1,2 However, they do not claim its superiority compared to other sedative agents. Some studies suggest that chloral hydrate is ineffective in a significant proportion of children.3,4 On the other hand, there are concerns about its safety, and gastrointestinal, cardiovascular, respiratory and carcinogenic effects have been reported.5-7
Journal of neurosurgical anesthesiology, 2015
Sedation for electroencephalography in uncooperative patients is a controversial issue because majority of sedatives, hypnotics, and general anesthetics interfere with the brain's electrical activity. Chloral hydrate (CH) is typically used for this sedation, and dexmedetomidine (DEX) was recently tested because preliminary data suggest that this drug does not affect the electroencephalogram (EEG). The aim of the present study was to compare the EEG pattern during DEX or CH sedation to test the hypothesis that both drugs exert similar effects on the EEG. A total of 17 patients underwent 2 EEGs on 2 separate occasions, one with DEX and the other with CH. The EEG qualitative variables included the phases of sleep and the background activity. The EEG quantitative analysis was performed during the first 2 minutes of the second stage of sleep. The EEG quantitative variables included density, duration, and amplitude of the sleep spindles and absolute spectral power. The results showed ...
Intranasal dexmedetomidine following failed chloral hydrate sedation in children
Anaesthesia, 2014
Chloral hydrate is the most commonly used sedative for paediatric diagnostic procedures in China with a success rate of around 80%. Intranasal dexmedetomidine is used for rescue sedation in our centre. This prospective investigation evaluated 213 children aged one month to 10 years who were not adequately sedated following administration of chloral hydrate. Children were randomly assigned to receive rescue intranasal dexmedetomidine at 1 lg.kg À1 (group 1), 1.5 lg.kg À1 (group 2) or 2 lg.kg À1 (group 3). The sedation level was assessed every 10 min using a modified observer's assessment of alertness/sedation scale. Successful rescue sedation in groups 1, 2 and 3 were 56 (83.6%), 66 (89.2%) and 51 (96.2%), respectively. Increasing the rescue dose was associated with an increased success rate with an odds ratio of 4.12 (95% CI 1.13-14.98), p = 0.032. We conclude that intranasal dexmedetomidine is effective for sedation in children who do not respond to chloral hydrate.