High dose chloral hydrate sedation for children undergoing CT
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S B Greenberg1, E N Faerber, C L Aspinall
1Department of Radiology, St. Christopher's Hospital for Children, Philadelphia, PA 19134-1095.
Insights
High dose oral chloral hydrate (80-100 mg/kg) is safe and effective for sedating children before CT scans. This study found minimal adverse reactions and a high success rate for motion-free imaging.
Area of Science:
- Pediatric imaging
- Pharmacology
- Radiology
Background:
- Chloral hydrate is a common sedative for pediatric CT scans.
- No prior prospective studies evaluated high-dose chloral hydrate safety and efficacy in children.
Purpose of the Study:
- To assess the safety and efficacy of high-dose oral chloral hydrate (80-100 mg/kg) for pediatric CT sedation.
Main Methods:
- Oral chloral hydrate (80-100 mg/kg, max 2g) administered to 295 children for 326 CT examinations.
- Adverse reactions, sedation success, and need for repeat scans were monitored.
Main Results:
- Adverse reactions occurred in 7% of children, most commonly vomiting (4.3%).
- Hyperactivity and respiratory symptoms were infrequent (<2%).
- Successful, motion-free CT scans achieved in 93% of cases, avoiding repeat scans.
Conclusions:
- High-dose oral chloral hydrate is a safe and effective sedation method for pediatric CT.
- It minimizes motion artifacts and the need for repeat imaging procedures.
Abstract:
Chloral hydrate is commonly used to sedate children before CT. However, no prospective study has been published of the safety and efficacy of chloral hydrate at high dose levels for children undergoing CT. We define high dose levels of oral chloral hydrate to be 80-100 mg/kg, with a maximum total dose of 2 g. High dose chloral hydrate sedation was administered orally to 295 children for 326 CT examinations. Adverse reactions occurred in 7% of the children, with vomiting being the most common (4.3% of children). Hyperactivity and respiratory symptoms each occurred in less than 2% of children. Prolonged sedation ( greater than 2 h) was not encountered in our series. Sedation was successful in producing motion free CT examinations, so that in 303 (93%) of the cases, no repeat CT scans were needed. We conclude that high dose oral chloral hydrate provides safe and effective sedation for children undergoing CT.