KL Yam, FT Yau

Abstract

Retrospective review was done on 282 children under chloral hydrate sedation for computerized tomography of brain or thorax, electroencephalogram, echocardiogram or brainstem auditory evoked potential studies. The study period was from 1 April, 1997 to 31 March, 1999. Standardized sedation protocol and checklist for pre-sedation assessment, monitoring and discharge assessment were used. The overall risk of prolonged sedation was 8.9%. No statistically significant difference in prolonged sedation could be shown among the different age groups or among the different dosage groups. There was no desaturation, vomiting or paradoxical excitation. Our study suggested the incidence of complications arising from sedation by chloral hydrate might be lower than reported when the maximum dosage of chloral hydrate was limited to 100 mg/kg or two gram in selected patients. A larger prospective study may be necessary to reassess the need for routine intensive monitoring in all children undergoing sedation by chloral hydrate alone.

對在 1997 年 4 月 1 日至 1999 年 3 月 31 日期間，因需行頭顱/胸部 CT、腦電圖、心電圖或腦幹聽覺誘發電位檢查而應用水合氯醛鎮靜的 282 例兒童臨床資料進行了回顧性分析。本研究採用標準化的鎮靜方案、鎮靜前評價分類、監護及出院評估。長期鎮靜的總危險度為 8.9%，在各年齡組或不同劑量組之間差別不大。所有患兒均未發現有氧飽和度下降、嘔吐或反常性興奮。本研究結果提示，若患兒水合氯醛最大用量低於 100 mg/kg 或 2 g，則其併發症發生率可以低於文獻報導。對單獨應用水合氯醛鎮靜的兒童是否常規需要密切監護，尚有待大樣本、前瞻性的研究進一步確定。