Singapore National Eye Centre, Singapore.
Ann Acad Med Singap. 2017 Apr;46(4):138-144.
Chloral hydrate (CH) sedation is routinely used in paediatric ophthalmic examination in Singapore as an alternative to examination under general anaesthesia. Despite CH's traditionally high success rates and relatively low rate of adverse events, there is little data on its safety and efficacy as a sedative for ophthalmic procedures in an Asian population.
A retrospective chart review was performed, including children who underwent CH sedation at the Singapore National Eye Centre from January 2012 to January 2015. Participants were given an initial dose of CH and a top-up dose if required. Univariate and multivariate analyses were performed on data collected.
CH sedation was successful in 144 of 153 children (94.1%). Of the 20 (13.0%) who required a top-up dose, 4 failed to sedate. The mean sedation onset was 29.4 minutes (SD: 24.3) and mean sedation duration was 56.5 minutes (SD: 24.0), with more than a third lasting more than 1 hour. The age of children, rather than initial dose of CH, was more relevant in determining success of sedation. Children who were >6 years old were 20.3 times more likely to fail sedation than those aged <2 years. During sedation, depression in the heart rate and a transient reduction of oxygen saturation was documented. All children recovered well post-sedation.
CH is a very useful sedative for paediatric ophthalmic procedures, especially in younger children. Children over 4 years old were more likely to fail sedation and require top-up doses. Alternative means of sedation may need to be considered in these cases.
水合氯醛（CH）镇静在新加坡的儿科眼科检查中经常被用作全身麻醉的替代方法。尽管 CH 传统上具有很高的成功率和相对较低的不良事件发生率，但关于其作为亚洲人群眼科手术镇静剂的安全性和有效性的数据很少。
对 2012 年 1 月至 2015 年 1 月在新加坡国家眼科中心接受 CH 镇静的儿童进行了回顾性图表审查。参与者给予初始剂量的 CH，如果需要，给予补充剂量。对收集的数据进行了单变量和多变量分析。
CH 镇静在 153 名儿童中的 144 名（94.1%）中成功。在需要补充剂量的 20 名儿童中，有 4 名未镇静。平均镇静开始时间为 29.4 分钟（SD：24.3），平均镇静持续时间为 56.5 分钟（SD：24.0），超过三分之一的时间超过 1 小时。儿童的年龄而不是 CH 的初始剂量与镇静成功更相关。年龄>6 岁的儿童镇静失败的可能性是年龄<2 岁的儿童的 20.3 倍。在镇静期间，记录了心率下降和氧饱和度短暂降低。所有儿童镇静后均恢复良好。
CH 是儿科眼科手术非常有用的镇静剂，尤其是在年幼的儿童中。年龄超过 4 岁的儿童更有可能镇静失败并需要补充剂量。在这些情况下，可能需要考虑其他镇静方法。
