Avlonitou Eirini, Balatsouras Dimitrios G, Margaritis Eleftherios, Giannakopoulos Polyvios, Douniadakis Dimitrios, Tsakanikos Michael
ENT Department of Pediatric Hospital Aglaia Kyriakou, Thivon & Levadias Street, GR-11527, Athens, Greece.
Int J Pediatr Otorhinolaryngol. 2011 Jun;75(6):760-3. doi: 10.1016/j.ijporl.2011.02.010. Epub 2011 Apr 29.
Chloral hydrate (CH) is an oral sedative widely used to sedate infants and young children during auditory brainstem response (ABR) testing. The aim of this study was to record effectiveness, complications and safety of CH as a sedative for ABR.
From January of 2003 until December of 2007, 1903 children were tested for ABR, 568 of them being under the age of 6 months. CH (8%) was used for sedation at a dose of 40 mg/kg with a repeat dose, if necessary, for an adequate sedation, in 20-30 min. We recorded the effectiveness of CH as a sedative for ABR examination, as well as all complications related to the use of CH such as vomiting, rash, hyperactivity, respiratory distress and apnea. The statistical method used was the absolute and percentage frequency distribution of the occurrences.
Sedation with CH was necessary to perform testing in 1591 (83.6%) of the examined children. However, in the population of the examined infants, only 341 (60%) were sedated with CH, because the remaining 227 (40%) fell asleep by themselves. Complications included hyperactivity in 152 children (8%), minor respiratory distress in 10 children (0.4%), vomiting in 217 children (11.4%), apnea in 4 children (0.2%) and rash in 10 children (0.4%). The complications of hyperactivity, vomiting and rash resolved without any medical treatment. The apnea cases were managed effectively by supplying ventilation to the children via a mask in the presence of an anesthesiologist.
The use of CH at a dose of 40 mg/kg up to 80 mg/kg is safe and effective when administered in a setting with adequate equipment and the presence of well trained personnel.
水合氯醛（CH）是一种口服镇静剂，广泛用于在听性脑干反应（ABR）测试期间使婴幼儿镇静。本研究的目的是记录水合氯醛作为ABR镇静剂的有效性、并发症及安全性。
从2003年1月至2007年12月，对1903名儿童进行了ABR测试，其中568名年龄在6个月以下。使用8%的水合氯醛，剂量为40mg/kg，必要时重复给药，在20 - 30分钟内达到充分镇静。我们记录了水合氯醛作为ABR检查镇静剂的有效性，以及与使用水合氯醛相关的所有并发症，如呕吐、皮疹、多动、呼吸窘迫和呼吸暂停。所采用的统计方法是事件发生的绝对频率和百分比频率分布。
在1591名（83.6%）受检儿童中，需要用水合氯醛进行镇静才能进行测试。然而，在受检婴儿群体中，只有341名（60%）用水合氯醛镇静，因为其余227名（40%）自行入睡。并发症包括152名儿童（8%）出现多动，10名儿童（0.4%）出现轻度呼吸窘迫，217名儿童（11.4%）出现呕吐，4名儿童（0.2%）出现呼吸暂停，10名儿童（0.4%）出现皮疹。多动、呕吐和皮疹并发症无需任何药物治疗即可缓解。呼吸暂停病例在有麻醉医生在场的情况下通过面罩给儿童通气得到有效处理。
在具备适当设备且有训练有素人员在场的情况下，以40mg/kg至80mg/kg的剂量使用水合氯醛是安全有效的。
