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Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination.
Paediatr Anaesth 2017; 27(6):629-636PA

Abstract

BACKGROUND AND AIM

Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate.

METHODS

One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg-1 , n = 71) or oral chloral hydrate (80 mg·kg-1 , n = 70). The primary endpoint was successful sedation to complete the examinations including slit-lamp photography, tonometry, anterior segment analysis, and refractive error inspection. The secondary endpoints included quality of eye position, intraocular pressure, onset time, duration of examination, recovery time, discharge time, any side effects during examination, and within 48 h after discharge.

RESULTS

Sixty-one children were sedated by dexmedetomidine with a success rate of 85.9%, which is significantly higher than that by chloral hydrate (64.3%) [OR 3.39, 95% CI: 1.48-7.76, P = 0.003]. Furthermore, children in the dexmedetomidine group displayed better eye position in anterior segment analysis than in chloral hydrate group median difference. All children displayed stable hemodynamics and none suffered hypoxemia in both groups. Oral chloral hydrate induced higher percentages of vomiting and altered bowel habit after discharge than dexmedetomidine.

CONCLUSIONS

Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children.

Authors+Show Affiliations

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.Department of anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28414899

Citation

Cao, Qianzhong, et al. "Comparison of Sedation By Intranasal Dexmedetomidine and Oral Chloral Hydrate for Pediatric Ophthalmic Examination." Paediatric Anaesthesia, vol. 27, no. 6, 2017, pp. 629-636.
Cao Q, Lin Y, Xie Z, et al. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. Paediatr Anaesth. 2017;27(6):629-636.
Cao, Q., Lin, Y., Xie, Z., Shen, W., Chen, Y., Gan, X., & Liu, Y. (2017). Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. Paediatric Anaesthesia, 27(6), pp. 629-636. doi:10.1111/pan.13148.
Cao Q, et al. Comparison of Sedation By Intranasal Dexmedetomidine and Oral Chloral Hydrate for Pediatric Ophthalmic Examination. Paediatr Anaesth. 2017;27(6):629-636. PubMed PMID: 28414899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. AU - Cao,Qianzhong, AU - Lin,Yiquan, AU - Xie,Zhubin, AU - Shen,Weihua, AU - Chen,Ying, AU - Gan,Xiaoliang, AU - Liu,Yizhi, Y1 - 2017/04/17/ PY - 2017/02/23/accepted PY - 2017/4/18/pubmed PY - 2018/3/9/medline PY - 2017/4/18/entrez KW - chloral hydrate KW - dexmedetomidine KW - ophthalmic examination KW - pediatric KW - sedation SP - 629 EP - 636 JF - Paediatric anaesthesia JO - Paediatr Anaesth VL - 27 IS - 6 N2 - BACKGROUND AND AIM: Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. METHODS: One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg-1 , n = 71) or oral chloral hydrate (80 mg·kg-1 , n = 70). The primary endpoint was successful sedation to complete the examinations including slit-lamp photography, tonometry, anterior segment analysis, and refractive error inspection. The secondary endpoints included quality of eye position, intraocular pressure, onset time, duration of examination, recovery time, discharge time, any side effects during examination, and within 48 h after discharge. RESULTS: Sixty-one children were sedated by dexmedetomidine with a success rate of 85.9%, which is significantly higher than that by chloral hydrate (64.3%) [OR 3.39, 95% CI: 1.48-7.76, P = 0.003]. Furthermore, children in the dexmedetomidine group displayed better eye position in anterior segment analysis than in chloral hydrate group median difference. All children displayed stable hemodynamics and none suffered hypoxemia in both groups. Oral chloral hydrate induced higher percentages of vomiting and altered bowel habit after discharge than dexmedetomidine. CONCLUSIONS: Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children. SN - 1460-9592 UR - https://www.unboundmedicine.com/medline/citation/28414899/Comparison_of_sedation_by_intranasal_dexmedetomidine_and_oral_chloral_hydrate_for_pediatric_ophthalmic_examination_ L2 - https://doi.org/10.1111/pan.13148 DB - PRIME DP - Unbound Medicine ER -