Ashrafi Mahmoud Reza, Mohebbi Hossein, Mohamadi Mahmoud, Azizi Elham, Zamani Gholam Reza, Tavasoli Alireza, Badv Reza Shervin, Hosseini Firozeh
Department of Pediatrics , Children's Medical Center ,Pediatrics Center of Excellence , Division of Pediatric Neurology , Growth and Development Research Center ,Tehran University of Medical Sciences, Tehran, Iran.
Department of Pediatric Neurology, AJA University of Medical Sciences, Tehran, Iran.
Iran J Child Neurol. 2020 Winter;14(1):85-92.
One of the difficulties to conduct electroencephalography (EEG) in pediatric patient population is that they are not always cooperative during the procedure. Different medications are used to induce sedation during EEG recording. In order to find a medication with the least adverse effects and high efficacy, the current study aimed at comparing clonidine and chloral hydrate as a premedication prior to EEG recording in pediatric population.
MATERIALS & METHODS: A prospective, randomized, single-blinded, controlled trial was conducted on 198 children (9 to 156 months old) to investigate the sedative and adverse effects of clonidine and chloral hydrate. Patients, partially sleep-deprived the night before, were randomly divided into two groups of clonidine (n=100) and chloral hydrate (n=98) on an alternative day basis.
The average sleep onset latency was significantly longer in the clonidine group than chloral hydrate group (the Mann-Whitney test, p <0.0001). Sleep duration ranged 15 to 150 minutes and it was not significantly different between the two groups (the Mann-Whitney test, p = 0.2). Drowsiness terminated faster with chloral hydrate than clonidine.Drowsiness after arousal was observed in 58% and 26.1% of patients in the clonidine and chloral hydrate groups, respectively; the difference between the groups was significant (the Mann-Whitney test, p = 0.058). EEG results were reported normal in 77 subjects in the chloral hydrate group (77%) and 69 subjects (69%) in the clonidine group (p = 0.161). Generalized epileptiform discharges were significant in the clonidine group (the Mann-Whitney test, p = 0.006).
The results of the current study showed that both 5% chloral hydrate (1 mL/kg) and clonidine (4 μg/kg) could be administered as a premedication prior to EEG recording in children, although drowsiness after arousal was higher with clonidine than chloral hydrate. However, the yield of generalized epileptiform discharges in the clonidine group was greater than that of the chloral hydrate group.
在儿科患者群体中进行脑电图（EEG）检查的困难之一在于，他们在检查过程中往往不配合。在脑电图记录期间，会使用不同的药物来诱导镇静。为了找到一种副作用最小且疗效高的药物，本研究旨在比较可乐定和水合氯醛作为儿科人群脑电图记录前的预处理药物。
对198名儿童（9至156个月大）进行了一项前瞻性、随机、单盲、对照试验，以研究可乐定和水合氯醛的镇静作用及不良反应。前一晚部分睡眠剥夺的患者，隔天被随机分为可乐定组（n = 100）和水合氯醛组（n = 98）。
可乐定组的平均入睡潜伏期明显长于水合氯醛组（曼-惠特尼检验，p <0.0001）。睡眠时间为15至150分钟，两组之间无显著差异（曼-惠特尼检验，p = 0.2）。水合氯醛导致的嗜睡比可乐定更快终止。可乐定组和水合氯醛组分别有58%和26.1%的患者在唤醒后出现嗜睡；两组之间的差异具有显著性（曼-惠特尼检验，p = 0.058）。水合氯醛组77名受试者（77%）和可乐定组69名受试者（69%）的脑电图结果报告为正常（p = 0.161）。可乐定组的广泛性癫痫样放电显著（曼-惠特尼检验，p = 0.006）。
本研究结果表明，5%水合氯醛（1 mL/kg）和可乐定（4 μg/kg）均可作为儿童脑电图记录前的预处理药物，尽管可乐定唤醒后嗜睡比水合氯醛更高。然而，可乐定组广泛性癫痫样放电的发生率高于水合氯醛组。
