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[Premedication in children--a clinical trial of bromazepam and chloral hydrate suppositories]
M Shimoyama1, T Mizuguchi, S Yorozu
1Department of Anesthesiology, Chiba University School of Medicine.
Insights
Chloral hydrate suppositories offer superior sedation for pediatric surgery compared to bromazepam, especially in younger children. Chloral hydrate provides effective sedation without delaying emergence from anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Surgery
Background:
- Anesthetic premedication is crucial for managing pediatric surgical patients.
- Bromazepam and chloral hydrate are commonly used premedicants.
Purpose of the Study:
- To compare the efficacy and safety of bromazepam and chloral hydrate suppositories as premedication in pediatric patients undergoing inguinal hernia repair.
- To evaluate the influence of age on the effects of these premedicants.
Main Methods:
- A study involving 141 pediatric patients (6 months to 7 years) undergoing scheduled radical operation for inguinal hernia.
- Patients received either bromazepam or chloral hydrate suppository.
- Comparison of sedative effects and emergence characteristics between the two drugs and two age groups (under 5 years and 5 years and older).
Main Results:
- Younger children (<5 years) required higher bromazepam doses than older children (≥5 years) for comparable sedation.
- Chloral hydrate demonstrated a more potent sedative effect than bromazepam in younger children.
- Both drugs were equally effective in older children.
- Bromazepam delayed emergence from anesthesia, while chloral hydrate allowed for clear and rapid awakening.
Conclusions:
- Chloral hydrate suppositories are more effective for short pediatric operations due to their strong sedative properties.
- Chloral hydrate is preferable as it does not negatively impact emergence from anesthesia.
- Age influences the sedative response to bromazepam in pediatric patients.
Abstract:
We performed a study on 141 pediatric patients between 6 months and 7 years of age who underwent scheduled radical operation for inguinal hernia, to evaluate bromazepam suppository and chloral hydrate suppository as anesthetic premedication for short pediatric operations. The study was also focused on the difference of the effects of the two drugs between two age groups: younger than 5 years, and 5 years and older. The younger age group required a larger bromazepam dose compared with the older age group, and in the younger group even the larger bromazepam dose did not produce a high sedative effect as chloral hydrate. In the older group, bromazepam and chloral hydrate were equally effective. In respect to emergence from anesthesia, bromazepam delayed emergence compared with chloral hydrate after which children awoke from anesthesia very clearly. Thus, chloral hydrate suppository seemed more useful as premedicants in short pediatric operations for its high sedative effect without affecting emergence.