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Psychological and behavioral effects of chloral hydrate in day-case pediatric surgery: a randomized, observer-blinded

Hae K Kil1, Won O Kim, Sang W Han

  • 1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. hkkil@yuhs.ac

Journal of Pediatric Surgery
|August 21, 2012
PubMed

Insights

Oral chloral hydrate significantly reduced preoperative anxiety and improved induction compliance in young boys undergoing orchiopexy. While it lowered postoperative pain, it did not impact emergence delirium or behavioral changes.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Child Psychology

Background:

  • Perioperative anxiety and behavioral issues are common in pediatric surgical patients.
  • Effective pharmacological interventions are sought to manage these phenomena.

Purpose of the Study:

  • To evaluate the efficacy of oral chloral hydrate in mitigating perioperative psychological and behavioral disturbances in young boys.
  • To assess the impact of chloral hydrate on anxiety, induction compliance, emergence delirium, postoperative pain, and behavioral changes.

Main Methods:

  • Prospective, randomized, observer-blinded study involving 100 boys (1-5 years) undergoing orchiopexy.
  • Participants received either oral chloral hydrate (40 mg/kg) or placebo 30 minutes pre-surgery.
  • Outcomes included anxiety scores, induction compliance, emergence delirium, postoperative pain, and behavioral changes.

Main Results:

  • Chloral hydrate group showed significantly lower anxiety scores (28.8 vs 45.7) and better induction compliance (4.8 vs 3.2).
  • Increased postoperative sedation (62.7% vs 20.4%) and decreased vomiting (2.0% vs 14.3%) were observed in the chloral hydrate group.
  • No significant differences in emergence delirium or maladaptive behavioral changes were noted between groups.

Conclusions:

  • Oral chloral hydrate effectively reduces preoperative anxiety and pain in young boys undergoing orchiopexy, improving induction compliance.
  • The medication did not significantly affect emergence delirium or postoperative maladaptive behaviors.
  • Chloral hydrate offers a viable option for managing specific perioperative psychological distress in pediatric surgery without hindering recovery.
Abstract

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