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Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies.

Abstract

AIM

Triclofos sodium (TFS) has been used for many years in children as a sedative for painless medical procedures. It is physiologically and pharmacologically similar to chloral hydrate, which has been censured for use in children with neurocognitive disorders. The aim of this study was to investigate the safety and efficacy of TFS sedation in a pediatric population with a high rate of neurocognitive disability.

METHODS

The database of the neurodiagnostic institute of a tertiary academic pediatric medical center was retrospectively reviewed for all children who underwent sedation with TFS in 2014. Data were collected on demographics, comorbidities, neurologic symptoms, sedation-related variables, and outcome.

RESULTS

The study population consisted of 869 children (58.2% male) of median age 25 months (range 5-200 months); 364 (41.2%) had neurocognitive diagnoses, mainly seizures/epilepsy, hypotonia, or developmental delay. TFS was used for routine electroencephalography in 486 (53.8%) patients and audiometry in 401 (46.2%). Mean (± SD) dose of TFS was 50.2 ± 4.9 mg/kg. Median time to sedation was 45 min (range 5-245), and median duration of sedation was 35 min (range 5-190). Adequate sedation depth was achieved in 769 cases (88.5%). Rates of sedation-related adverse events were low: apnea, 0; desaturation ≤ 90%, 0.2% (two patients); and emesis, 0.35% (three patients). None of the children had hemodynamic instability or signs of poor perfusion. There was no association between desaturations and the presence of hypotonia or developmental delay.

CONCLUSION

TFS, when administered in a controlled and monitored environment, may be safe for use in children, including those with underlying neurocognitive disorders.

Authors+Show Affiliations

Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. eytank@clalit.org.il. Pediatric Sedation Services, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. eytank@clalit.org.il. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. eytank@clalit.org.il.Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.Institute of Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.Pediatric Sedation Services, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31292919

Citation

Kaplan, Eytan, et al. "Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies." Paediatric Drugs, 2019.
Kaplan E, Daka A, Weissbach A, et al. Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies. Paediatr Drugs. 2019.
Kaplan, E., Daka, A., Weissbach, A., Kraus, D., Kadmon, G., Milkh, R., & Nahum, E. (2019). Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies. Paediatric Drugs, doi:10.1007/s40272-019-00346-6.
Kaplan E, et al. Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies. Paediatr Drugs. 2019 Jul 11; PubMed PMID: 31292919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Triclofos Sodium for Pediatric Sedation in Non-Painful Neurodiagnostic Studies. AU - Kaplan,Eytan, AU - Daka,Ayman, AU - Weissbach,Avichai, AU - Kraus,Dror, AU - Kadmon,Gili, AU - Milkh,Rachel, AU - Nahum,Elhanan, Y1 - 2019/07/11/ PY - 2019/7/12/entrez JF - Paediatric drugs JO - Paediatr Drugs N2 - AIM: Triclofos sodium (TFS) has been used for many years in children as a sedative for painless medical procedures. It is physiologically and pharmacologically similar to chloral hydrate, which has been censured for use in children with neurocognitive disorders. The aim of this study was to investigate the safety and efficacy of TFS sedation in a pediatric population with a high rate of neurocognitive disability. METHODS: The database of the neurodiagnostic institute of a tertiary academic pediatric medical center was retrospectively reviewed for all children who underwent sedation with TFS in 2014. Data were collected on demographics, comorbidities, neurologic symptoms, sedation-related variables, and outcome. RESULTS: The study population consisted of 869 children (58.2% male) of median age 25 months (range 5-200 months); 364 (41.2%) had neurocognitive diagnoses, mainly seizures/epilepsy, hypotonia, or developmental delay. TFS was used for routine electroencephalography in 486 (53.8%) patients and audiometry in 401 (46.2%). Mean (± SD) dose of TFS was 50.2 ± 4.9 mg/kg. Median time to sedation was 45 min (range 5-245), and median duration of sedation was 35 min (range 5-190). Adequate sedation depth was achieved in 769 cases (88.5%). Rates of sedation-related adverse events were low: apnea, 0; desaturation ≤ 90%, 0.2% (two patients); and emesis, 0.35% (three patients). None of the children had hemodynamic instability or signs of poor perfusion. There was no association between desaturations and the presence of hypotonia or developmental delay. CONCLUSION: TFS, when administered in a controlled and monitored environment, may be safe for use in children, including those with underlying neurocognitive disorders. SN - 1179-2019 UR - https://www.unboundmedicine.com/medline/citation/31292919/Triclofos_Sodium_for_Pediatric_Sedation_in_Non-Painful_Neurodiagnostic_Studies L2 - https://dx.doi.org/10.1007/s40272-019-00346-6 DB - PRIME DP - Unbound Medicine ER -