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Chloral hydrate to study auditory brainstem response.

Mariana Lopes Fávero1, Fabiana Amaral Sanches Ponce, Marcio Ricardo Barros Pio

  • 1Otorhinolaryngology Department - FMUSP, ENT - DERDIC/PUCSP. lopessquare@ig.com.br

Brazilian Journal of Otorhinolaryngology
|September 14, 2010
PubMed
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Chloral hydrate (CH) effectively sedates children for auditory brainstem response (ABR) testing. A dose of 56 mg/kg showed a statistically significant improvement in sleep induction compared to 50 mg/kg.

Area of Science:

  • Pediatric Anesthesiology
  • Clinical Pharmacology

Background:

  • Chloral hydrate (CH) is a widely used sedative-hypnotic in pediatric procedures.
  • Its use is favored due to minimal respiratory and cardiac depression.
  • Systematic evaluation of CH for Auditory Brainstem Response (ABR) testing is needed.

Purpose of the Study:

  • To evaluate the efficacy of chloral hydrate in inducing sleep for pediatric ABR.
  • To establish optimal dosing and administration protocols for CH in this context.

Main Methods:

  • A prospective cross-sectional study involving 41 children without pre-existing cardiopulmonary conditions.
  • Initial CH dose of 50 mg/kg, with a potential 6 mg/kg boost dose after 30 minutes if sedation was insufficient.
  • Sleep induction was assessed within one hour of the initial dose.

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Main Results:

  • A total of 56 mg/kg of CH demonstrated a statistically significant improvement in sleep induction (p<0.05) compared to 50 mg/kg.
  • 23 children achieved sleep within 30 minutes with the initial 50 mg/kg dose.
  • 16 children required the 6 mg/kg boost dose, and 13 fell asleep after 30 minutes; 2 experienced respiratory complications.

Conclusions:

  • Chloral hydrate at 50 mg/kg with an optional 6 mg/kg boost dose is effective for pediatric ABR testing within one hour.
  • While generally safe, complications can occur irrespective of the administered dose.
  • The 56 mg/kg total dose offers a statistically significant advantage for sleep induction.