Author/Authors :
Azizkhani، Reza نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Kanani، Soheila نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Sharifi، Ali نويسنده Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran , , Golshani، Keihan نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Masoumi، Babak نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Ahmadi، Omid نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran ,
Abstract :
Introduction: The increasing use of diagnostic imaging in pediatric medicine has resulted in growing need for
procedural sedation and analgesia (PSA) to minimize motion artifacts during procedures. The drug of choice in
pediatric PSA was not introduced till now. The aim of the present study was comparison of oral chloral hydrate
(OCH) and rectal sodium thiopental (RST) in pediatric PSA.
Methods: In the present randomized clinical trial, 2?6 years old pediatrics who referred for performing brain
computed tomography scan was enrolled and were randomly divided in to two groups. OCH (50mg/kg) and RST
(25mg/kg) were prescribed and a trained nurse recorded the time from drug prescription to receiving the conscious
sedation (onset of action), the total time period which the patient has the Ramsay score?4 (duration of
action), and adverse effect of agents. Mann?Whitney U test and chi?squared test, and Non?parametric analysis of
covariance (ANCOVA) were used for comparisons. Results: One hundred and forty children were entered to two
groups of OCH and RST, randomly. The patients of two groups had similar age, sex, weight, and baseline vital
signs except for diastolic blood pressure (p < 0.001). The onset of action in OCH and RST groups were 24.5±6.1and
28.7±5.2 minutes, respectively (p < 0.001). Duration of action in OCH and RST groups were 12.9±2.8 minutes and
13.7±2.6 minutes, respectively (p=0.085). Non parametric ANCOVA revealed that only diastolic blood pressure
was affected by drug prescription (p=0.001). In 11(15.7%) patients in RST group, diarrhea was observed during
24 hours (p=0.001). Oxygen desaturation was observed only in two patients, both in OCH group. Conclusion:
Each of the sedative has advantages and disadvantages that should be considered when selecting one for inducing
short?term sedation. It seems that rectal sodium thiopental and oral chloral hydrate are equally effective in pediatric
PSA and based on patient’s condition we can administrate one of these agents.
