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A comparison of chloral hydrate and diazepam sedation in young children
M M Badalaty1, M I Houpt, S R Koenigsberg
1University of Medicine and Dentistry of New Jersey.
Insights
This study found diazepam and chloral hydrate offer similar sedation for young children
Area of Science:
- Pediatric Dentistry
- Pharmacology
- Sedation Medicine
Background:
- Behavioral management is crucial for pediatric dental care.
- Sedation is often necessary for anxious or uncooperative young children.
- Diazepam and chloral hydrate are common sedative agents.
Purpose of the Study:
- To compare the efficacy of two doses of diazepam (0.3 mg/kg and 0.6 mg/kg) with chloral hydrate (50 mg/kg) for sedating young children.
- To evaluate the sedative effects and vital signs during dental treatment.
Main Methods:
- A double-blind study involving 30 healthy children (20-48 months) requiring sedation.
- Administration of diazepam or chloral hydrate in a randomized, crossover design.
- Monitoring of sleep, movement, crying, and vital signs (pulse, respiration, oxygen saturation).
Main Results:
- No significant differences in movement or crying between diazepam and chloral hydrate.
- Chloral hydrate resulted in more children being asleep within the first 60 minutes.
- Vital signs remained stable, with transient pulse increases during stimulation.
Conclusions:
- Diazepam and chloral hydrate demonstrate comparable sedative effects in young children undergoing dental treatment.
- Chloral hydrate may induce sleep more rapidly in the initial phase of treatment.
- Both agents are effective with similar side effect profiles (e.g., vomiting).
Abstract:
The purpose of this study was to compare a high and low dose of diazepam with chloral hydrate in the sedation of young children. Thirty healthy children between the ages of 20 and 48 months, with a mean age of 33.5 months, participated in the study. All children exhibited negative behavior during a screening visit and required at least two restorative appointments with the use of sedation. A dose of either 0.3 mg/kg or 0.6 mg/kg of diazepam at one visit and 50 mg/kg of chloral hydrate at another visit was administered in a double-blind manner. All children were restrained in a Papoose Board with auxiliary head restraint and received 50% nitrous oxide/oxygen during treatment. The degree of sleep, body movement, crying, pulse rate, respiratory rate, and blood oxygen saturation were monitored before and during the operative procedures. Vital signs remained essentially unchanged during treatment, except for transitory elevations of the pulse during periods of stimulation. There were no statistically significant differences among the three drug regimens with regard to movement and crying. Significantly more patients who received chloral hydrate were asleep than when either dose of diazepam was given during the first 60 min of treatment. The only side effect found was vomiting in one patient with both chloral hydrate and diazepam. It is concluded that the sedative effects of chloral hydrate and diazepam are similar when young children are sedated for dental treatment. The use of diazepam might be more advantageous because chloral hydrate produces more sleep during the first hour of treatment.