4CPS-166 Is there still a place for chloral hydrate syrup in hospital?

BackgroundSedation is frequently essential for successful magnetic resonance imaging (MRI) for infant and child patients. Chloral hydrate syrup (CHS) remains the only product used orally for this purpose in the Specialty Hospital, Ibn Sina University Hospital of Rabat, Morocco.PurposeThis study evaluates the use and economic interest of the CHS administration for sedation in infants and children undergoing MRI in our hospital.Material and methodsProspective study included 30 infants and children, 8 to 48 months’ old (mean, 20.71±13.42 months), who were given oral chloral hydrate, 50 mg/kg, for sedation before MRI. The study was limited to children who weighed 25 kg or less. Sedation was considered successful when MRI studies were completed and at least 95% of the images had few or no motion artifacts.ResultsThe overall length of time to achieve sedation ranged from 8 to 30 min (13.5±11.33 min); the overall mean duration of sedation ranged from 10 to 45 min (29.5±5.02 min); and the overall mean length of time to return to normal activity was 30 min to 3 hour (47.3±16.2 min). Other studies reported that chloral hydrate was more effective than midazolam in facilitating the completion of painless imaging studies, although it has a longer onset and duration, and reported minimal adverse events (the only side effect observed was vomiting in 15% of children).1 2 On the pharmaco-economic side, the hospital preparation of the CHS 5% in a bottle of 100 ml costs €1.85. The direct cost to prepare the sedation is €0.37 for each child of 20 kg versus €1.24 for sedation of the child with the same weight by Midazolam.ConclusionThe low adverse events for CHS, and the much lower cost of its use to induce sedation for a short time has made CHS our preference for sedation in infants and children undergoing MRI in our hospital.References and/or acknowledgements1. Roach CL, Husain N, Zabinsky J, et al. Moderate sedation for echocardiography of preschoolers. Pediatr Cardiol2010;31:469–73.2. Hare M. Question 1: chloral hydrate or midazolam: which is better for sedating children for painless diagnostic imaging?Arch Dis Child2012;97:750–2.No conflict of interest.