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KMID : 1130320080510101047
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Korean Journal of Pediatrics
2008 Volume.51 No. 10 p.1047 ~ p.1051
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Kim Jung-Hwa
Kim Min-Sun
Lee Dae-Yeol
Kim Sun-Jun
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Abstract
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Purpose : This study aims to evaluate the efficacy and safety of sedatives for pediatric patients using noninvasive
procedures.
Methods : We performed a prospective study in 4 4 6 (aged 1 month-2 1 y) consecutive pediatric patients undergoing sedation to study noninvasive sedation techniques from February to August 2 0 0 7 . We reviewed demographic data, sedative drugs, dosage, complications, and successful rates of sedation according to the underlying diseases.
Results : The overall successful rate of sedation was 4 3 5 /4 4 6 (9 7 .5%). The overall rate of successful sedation using chloral hydrate was 9 9 .1% (4 2 0 /4 2 4 ), and was 7 0 .6% (1 2 /1 7 ) and 6 0 .0% (3 /5 ) with ketamine and midazolam, respectively. Of the neurologic patients (n=1 7 2 , aged 1 month to 2 1 years), 1 3 6 patients were sedated for EEGs, 5 patients for renal scans, and 3 1 patients for neuroimaging studies such as brain CT or MRI. All non-neurological patients (n=2 7 4 , aged 1 month to 5 years) were diagnosed with urinary tract infection and sedated for renal scan. The overall success rate of sedation for this group was 9 9 .6%(2 7 3 /2 7 4 ). Atotal of 1 4 adverse events were observed (3 .1%). Most adverse reactions were mild in severity and clinically insignificant.
Conclusion : Using chloral hydrate alone has enough effect to sedate non-neurologic patients. However, neurologic patients in the severe course group, especially those suffering from intractable epilepsy, autism, or severe cerebral palsy, must be medicated with chloral hydrate 2 times at most; instead, injections of ketamine or midazolam in the early stage may result in a more promising outcome.
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KEYWORD
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Moderate sedation, Method, Child
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