Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel.
Pediatric Sedation Services, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Paediatr Drugs. 2019 Oct;21(5):371-378. doi: 10.1007/s40272-019-00346-6.
Triclofos sodium (TFS) has been used for many years in children as a sedative for painless medical procedures. It is physiologically and pharmacologically similar to chloral hydrate, which has been censured for use in children with neurocognitive disorders. The aim of this study was to investigate the safety and efficacy of TFS sedation in a pediatric population with a high rate of neurocognitive disability.
The database of the neurodiagnostic institute of a tertiary academic pediatric medical center was retrospectively reviewed for all children who underwent sedation with TFS in 2014. Data were collected on demographics, comorbidities, neurologic symptoms, sedation-related variables, and outcome.
The study population consisted of 869 children (58.2% male) of median age 25 months (range 5-200 months); 364 (41.2%) had neurocognitive diagnoses, mainly seizures/epilepsy, hypotonia, or developmental delay. TFS was used for routine electroencephalography in 486 (53.8%) patients and audiometry in 401 (46.2%). Mean (± SD) dose of TFS was 50.2 ± 4.9 mg/kg. Median time to sedation was 45 min (range 5-245), and median duration of sedation was 35 min (range 5-190). Adequate sedation depth was achieved in 769 cases (88.5%). Rates of sedation-related adverse events were low: apnea, 0; desaturation ≤ 90%, 0.2% (two patients); and emesis, 0.35% (three patients). None of the children had hemodynamic instability or signs of poor perfusion. There was no association between desaturations and the presence of hypotonia or developmental delay.
TFS, when administered in a controlled and monitored environment, may be safe for use in children, including those with underlying neurocognitive disorders.
三氯氧磷钠（TFS）多年来一直被用于儿童无痛医疗程序的镇静剂。它在生理和药理学上与水合氯醛相似，后者因在有神经认知障碍的儿童中使用而受到谴责。本研究的目的是调查 TFS 镇静在高神经认知障碍率的儿科人群中的安全性和疗效。
回顾性分析 2014 年在一家三级学术儿科医疗中心神经诊断研究所接受 TFS 镇静的所有儿童的数据库。收集人口统计学、合并症、神经系统症状、镇静相关变量和结果的数据。
研究人群由 869 名儿童（58.2%为男性）组成，中位年龄为 25 个月（范围为 5-200 个月）；364 名（41.2%）有神经认知诊断，主要为癫痫/癫痫、张力减退或发育迟缓。TFS 用于 486 名（53.8%）患者的常规脑电图和 401 名（46.2%）患者的听力计。TFS 的平均（±标准差）剂量为 50.2±4.9mg/kg。镇静中位时间为 45 分钟（范围 5-245），镇静中位时间为 35 分钟（范围 5-190）。769 例（88.5%）达到足够的镇静深度。镇静相关不良事件发生率低：呼吸暂停，0；饱和度≤90%，0.2%（两名患者）；呕吐，0.35%（三名患者）。无儿童出现血流动力学不稳定或灌注不良迹象。饱和度与张力减退或发育迟缓的存在之间无关联。
在受控和监测的环境下，TFS 可能对包括有潜在神经认知障碍的儿童在内的儿童安全使用。
