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Effect of oral chloral hydrate sedation on the intraocular pressure measurement
1Department of Ophthalmology, Children's National Medical Center, Washington, DC 20010.
Insights
Oral chloral hydrate effectively sedates young children for intraocular pressure (IOP) measurement. This study found no significant changes in IOP in normal or glaucoma patients after sedation, ensuring accurate readings.
Area of Science:
- Ophthalmology
- Pediatrics
- Pharmacology
Background:
- Accurate intraocular pressure (IOP) measurement is crucial for diagnosing and managing pediatric glaucoma.
- Sedation is often required for IOP measurement in young children, but its effect on IOP is not well-established.
Purpose of the Study:
- To evaluate the effect of high-dose oral chloral hydrate sedation on intraocular pressure (IOP) measurements in children under 6 years of age.
- To assess the safety and efficacy of this sedation protocol for IOP measurement in both normal and glaucomatous eyes.
Main Methods:
- Intraocular pressure (IOP) was measured in 50 normal children and 10 glaucoma patients using Perkins' tonometer and Digilab pneumatonographer-tonometer.
- Measurements were repeated after administering oral chloral hydrate (100 mg/kg for the first 10 kg, then 50 mg/kg for additional weight).
Main Results:
- No statistically significant changes in IOP were observed before and after chloral hydrate administration in normal children (Pneuma and Perkins) or in glaucomatous eyes (Pneuma and Perkins).
- Chloral hydrate provided effective sedation in children under 6 years old.
- No significant side effects were reported, although some children resisted swallowing the medication.
Conclusions:
- High-dose oral chloral hydrate is a safe and effective sedative for IOP measurement in young children.
- This sedation protocol does not alter IOP readings, allowing for reliable assessment in both healthy and glaucomatous eyes.
Abstract:
We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 6 years of age and 10 glaucoma patients with the Perkins' hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). The measurements were repeated after oral chloral hydrate administration in the dose of 100 mg/kg body weight for the first 10 kg plus 50 mg/kg for every additional kg. There were no clinically or statistically significant changes in IOP measured before and after chloral hydrate in the 50 normal children (Pneuma: mean = 14.74 +/- 1.27 mm Hg vs 14.74 +/- 0.96 mm Hg; P > .05; Perkins: mean = 5.86 +/- 1.69 mm Hg vs 5.61 +/- 1.50 mm Hg; P > .05) or in the 15 glaucomatous eyes (Pneuma: mean = 28.93 +/- 5.26 vs 28.47 +/- 4.42 mm Hg; Perkins: mean = 20.27 +/- 5.36 vs 19.53 +/- 4.49 mm Hg; P > 0.05). Although some children did resist swallowing the bitter-tasting medicine, no significant side effects were encountered. The high-dose oral chloral hydrate protocol resulted in efficient sedation in children below the age of 6 years, without any alteration of the IOP levels in both normal and glaucomatous eyes.