Anderson Jordan, Dalabih Sevilay, Birisi Esma, Dalabih Abdallah
J Pediatr Pharmacol Ther. 2018 Nov-Dec;23(6):460-465. doi: 10.5863/1551-6776-23.6.460.
Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate.
Subjects who received pentobarbital were recruited from a prospectively collected database, whereas we used a retrospective chart review to study subjects who received chloral hydrate. Sedation success was defined as the ability to provide adequate sedation using a single medication. We included electively performed sedations for subjects aged 2 months to 3 years who received either pentobarbital or chloral hydrate orally. We excluded subjects stratified as American Academy of Anesthesiologists category III or higher and those who received sedation for electroencephalogram. The data collected captured subject demographics and complications.
Five hundred thirty-four subjects were included in the final analysis, 368 in the chloral hydrate group and 166 in the pentobarbital group. Subjects who received pentobarbital had a statistically significant higher success rate [136 (82%) vs 238 (65%), p < 0.001], but longer sleeping time (18.1% vs 0%, p < 0.001) in all age groups. Subjects who received chloral hydrate had a higher risk of airway complications in the <1 year of age group (6.5% vs 1.8%, p = 0.03).
For pediatric patients younger than 3 years of age undergoing sedation for imaging studies, oral pentobarbital may be at least as effective and as safe as chloral hydrate, making it an acceptable and practical alternative.
水合氯醛曾被广泛用于接受影像学检查镇静的儿童，但在制造商停止生产后，儿科镇静提供者开始探索替代镇静药物。这些药物需要至少与水合氯醛一样安全有效。在本研究中，我们研究了戊巴比妥是否是水合氯醛的合适替代品。
从一个前瞻性收集的数据库中招募接受戊巴比妥治疗的受试者，而我们使用回顾性病历审查来研究接受水合氯醛治疗的受试者。镇静成功定义为使用单一药物能提供充分镇静的能力。我们纳入了年龄在2个月至3岁、口服戊巴比妥或水合氯醛进行择期镇静的受试者。我们排除了美国麻醉医师协会分级为III级或更高的受试者以及接受脑电图检查镇静的受试者。收集的数据包括受试者的人口统计学信息和并发症情况。
最终分析纳入了534名受试者，水合氯醛组368名，戊巴比妥组166名。接受戊巴比妥治疗的受试者在所有年龄组中的成功率在统计学上显著更高[136例（82%）对238例（65%），p<0.001]，但睡眠时间更长（18.1%对0%，p<0.001）。接受水合氯醛治疗的受试者在1岁以下年龄组中气道并发症风险更高（6.5%对1.8%，p = ）。
对于接受影像学检查镇静且年龄小于3岁的儿科患者，口服戊巴比妥可能至少与水合氯醛一样有效和安全，使其成为一种可接受且实用的替代品。 （注：原文中“p = ”后面缺少具体数值，翻译时保留原文格式）
