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Moderate sedation for echocardiography of preschoolers

Carol Lafayette Roach1, Nazia Husain, Jennifer Zabinsky

  • 1The Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155-3009, USA. clroach@bellsouth.net

Pediatric Cardiology
|January 5, 2010
PubMed

Insights

Chloral hydrate is the preferred sedation for preschooler echocardiograms, offering fast onset and high success rates. It is also significantly more cost-effective for moderate sedation compared to deep sedation.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Medical Economics

Background:

  • Sedation is often necessary for echocardiograms in preschoolers.
  • Previous sedation protocols varied, necessitating a comparative analysis.

Purpose of the Study:

  • To compare the efficacy and safety of different sedation drug regimens in preschool-aged children undergoing echocardiograms.
  • To analyze the cost differences between moderate and deep sedation for these procedures.

Main Methods:

  • A retrospective study of 703 children (ages 2-4) from 2001-2007.
  • Comparison of four sedation regimens: chloral hydrate (CH), CH with diphenhydramine (CH+D), CH with hydroxyzine hydrochloride (CH+H), and midazolam.
  • Analysis of sedation onset, duration, success rates, complications, and associated costs.

Main Results:

  • Chloral hydrate (CH) demonstrated the fastest onset of sedation (30 min) and high success rates (97%).
  • CH+D resulted in the most prolonged sedations (13%).
  • Moderate sedation averaged $709, while deep sedation averaged $3,628, with minimal complications across all groups.

Conclusions:

  • Chloral hydrate is an effective and fast-acting agent for preschooler echocardiogram sedation.
  • Its favorable safety profile, high success rate, and significantly lower cost for moderate sedation make it the preferred choice.
  • Cost-effectiveness analysis highlights the economic benefits of utilizing chloral hydrate for moderate sedation.

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