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Melatonin versus chloral hydrate on sleep induction for recording electroencephalography in children: a randomized
Bahareh Fazli1, Seyed-Ahmad Hosseini2, Nasser Behnampour3
1Faculty of Medicine.
Insights
Melatonin and chloral hydrate are effective for pediatric EEG sedation. Melatonin offers faster recovery and fewer side effects than chloral hydrate for pediatric electroencephalography (EEG) sleep induction.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Diagnostic Imaging
Background:
- Electroencephalography (EEG) is crucial for diagnosing pediatric seizures.
- Current EEG protocols often involve partial sleep deprivation and sedative medications.
- Evaluating alternative sedatives for improved pediatric EEG procedures is necessary.
Purpose of the Study:
- To compare the efficacy of melatonin versus chloral hydrate for sleep induction in pediatric EEG recordings.
- To assess sedation onset, duration, recovery time, and side effects of both agents.
- To determine the impact of these sedatives on the detection of epileptiform waves in pediatric EEGs.
Main Methods:
- A parallel-blinded randomized clinical trial involving 78 children aged 6 months to 5 years.
- Participants were randomized to receive either melatonin (0.4 mg/kg) or chloral hydrate (0.5 ml/kg).
- Key outcomes included sedation start and duration, recovery time, adverse events, and EEG findings, analyzed using SPSS (significance P<0.05).
Main Results:
- Both melatonin (92%) and chloral hydrate (95%) showed high success rates in sedation induction (P=0.5).
- Sedation onset and duration were comparable between the two groups (P>0.1).
- Melatonin demonstrated significantly shorter recovery times (P<0.001) and a lower incidence of mild side effects (P=0.013) compared to chloral hydrate.
Conclusions:
- Melatonin is as effective as chloral hydrate for inducing sedation in pediatric EEG.
- Melatonin offers advantages of faster recovery and a better safety profile.
- These findings support melatonin as a favorable alternative for pediatric EEG procedures.
Background:
Electroencephalography (EEG) plays an essential role in the diagnosis of seizures. EEG recording in children is done with partial sleep deprivation and sedative drugs. To compare the effectiveness of melatonin and chloral hydrate on sleep induction and EEG recording in children.
Materials And Methods:
In a parallel blinded randomized clinical trial study, 78 patients (6 months-5 years) were included to record EEG. Patients were randomly divided into two groups to receive melatonin (0.4 mg/kg) or chloral hydrate (0.5 ml/kg). After receiving the sedative drug, the start and duration of sedation, recovery time, side effects, and epileptiform waves in the EEG were recorded. The data was analyzed using SPSS version 16, and the significance level was determined to be less than 0.05.
Results:
A total of 78 children, including 34 girls (43.6%) and 44 boys (56.4%) (average age of 27.15±17.15 months), were examined. Success in the induction of sedation was reported by melatonin in 36 patients (92%) and chloral hydrate in 37 patients (95%), which was similar between the two drugs (P=0.5). The start time (P=0.134) and the duration of sedation (P=0.408) were alike between the two drugs. However, compared to the chloral hydrate, the recovery time in the melatonin group was significantly shorter (P<0.001). Side effects were not seen in melatonin, while six children (15%) using chloral hydrate had mild side effects (P=0.013). Epileptiform waves in EEGs were reported to be similar and positive for melatonin in 18 children (50%) and chloral hydrate in 16 children (43%) (P=0.410).
Conclusion:
The findings show that using melatonin in the dose prescribed in this study had similar effects to success in inducing sedation with the minimum quantity of chloral hydrate. Regardless of the start time and duration of sedation, the shorter recovery time and the absence of side effects are the advantages of using melatonin.
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