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Arch Plast Surg. 2014 Jan;41(1):40-4. doi: 10.5999/aps.2014.41.1.40. Epub 2014 Jan 13.

Optimal initial dose of chloral hydrate in management of pediatric facial laceration.

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1
Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine, Gyeongju, Korea.

Abstract

BACKGROUND:

Chloral hydrate (CH) is the primary agent most commonly used for pediatric sedation prior to diagnostic, therapeutic procedures. In the management of pediatric facial laceration, the initial dose of CH has to balance the need for adequate sedation against the need to minimize sedative complications.

METHODS:

A retrospective review of medical records of 834 children who visited our emergency room for facial lacerations from August 2010 to September 2012 was conducted. They were divided into six groups on the basis of the initial dose of CH administered. Further, each group was compared with the standard group (70 to ≤80 mg/kg) with respect to sedation success, augmentation dose, failed sedation, time to procedure, and time of stay.

RESULTS:

With respect to the complication rate, only group 1 (range, 40 to ≤50 mg/kg) showed a significantly lower complication rate. In the case of all the other variables considered, there were no significant differences among any of the groups.

CONCLUSIONS:

An initial CH dose of 48±2 mg/kg does not negatively affect the success rate of sedation or the need for additional sedative during the primary closure of facial lacerations in pediatric patients. Further, lower doses reduce the incidences of adverse effects and do not delay procedure readiness. Therefore, 48±2 mg/kg of CH can be considered the optimal initial dose for pediatric sedation.

KEYWORDS:

Child; Chloral hydrate; Conscious sedation; Infant; Sutures

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