Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination
Summary 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...
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| Veröffentlicht in: | Pediatric anesthesia 2017-06, Vol.27 (6), p.629-636 |
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| creator | Cao, Qianzhong Lin, Yiquan Xie, Zhubin Shen, Weihua Chen, Ying Gan, Xiaoliang Liu, Yizhi Veyckemans, Francis |
| description | Summary
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. |
| doi_str_mv | 10.1111/pan.13148 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1889382306</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1889382306</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-bb93b0c3645e856fd11c29d073425de02635f71a2e1ea9d3bcfdd27dcf3c2b813</originalsourceid><addsrcrecordid>eNp1kctKxDAUhoMo3he-gATc6KIzuTSdZCmDNxB1oeuSJqdMpE1q0kHn7Y0z6kIwm_NDPj4O50fohJIJzW86aD-hnJZyC-3TsiKFEopt50yFKERVij10kNIrIZSziu2iPSbLTCu1j-I89IOOLgWPQ4sTWD26nJsVdn6M2uukO2zhowcLY-iddR6w9haHmD_MolvPxcpGPQJuQ8QDWKfH6AwOw2Jc6K7PET507_zafYR2Wt0lOP6eh-jl-up5flvcP97czS_vC8MFl0XTKN4Qw_P6IEXVWkoNU5bMeMmEBcIqLtoZ1QwoaGV5Y1pr2cyalhvWSMoP0fnGO8TwtoQ01r1LBrpOewjLVFMpFZeMkyqjZ3_Q17CMPm-XKSU4oaKSmbrYUCaGlCK09RBdr-OqpqT-KqLORdTrIjJ7-m1cNvl0v-TP5TMw3QDvroPV_6b66fJho_wEf3qT7g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1895301568</pqid></control><display><type>article</type><title>Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Cao, Qianzhong ; Lin, Yiquan ; Xie, Zhubin ; Shen, Weihua ; Chen, Ying ; Gan, Xiaoliang ; Liu, Yizhi ; Veyckemans, Francis</creator><contributor>Veyckemans, Francis</contributor><creatorcontrib>Cao, Qianzhong ; Lin, Yiquan ; Xie, Zhubin ; Shen, Weihua ; Chen, Ying ; Gan, Xiaoliang ; Liu, Yizhi ; Veyckemans, Francis ; Veyckemans, Francis</creatorcontrib><description>Summary
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.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.13148</identifier><identifier>PMID: 28414899</identifier><language>eng</language><publisher>France: Wiley Subscription Services, Inc</publisher><subject>Administration, Intranasal ; Administration, Oral ; Cataract - congenital ; Cataract - diagnosis ; Child, Preschool ; chloral hydrate ; Chloral Hydrate - administration & dosage ; Chloral Hydrate - adverse effects ; Conscious Sedation - adverse effects ; Conscious Sedation - methods ; dexmedetomidine ; Dexmedetomidine - administration & dosage ; Dexmedetomidine - adverse effects ; Eye ; Female ; Humans ; Hypnotics and Sedatives - administration & dosage ; Hypnotics and Sedatives - adverse effects ; Hypoxemia ; Infant ; Male ; ophthalmic examination ; pediatric ; Pediatrics ; Physical Examination - methods ; Quality ; sedation ; Treatment Outcome</subject><ispartof>Pediatric anesthesia, 2017-06, Vol.27 (6), p.629-636</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-bb93b0c3645e856fd11c29d073425de02635f71a2e1ea9d3bcfdd27dcf3c2b813</citedby><cites>FETCH-LOGICAL-c3538-bb93b0c3645e856fd11c29d073425de02635f71a2e1ea9d3bcfdd27dcf3c2b813</cites><orcidid>0000-0002-8167-8272</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpan.13148$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpan.13148$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28414899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Veyckemans, Francis</contributor><creatorcontrib>Cao, Qianzhong</creatorcontrib><creatorcontrib>Lin, Yiquan</creatorcontrib><creatorcontrib>Xie, Zhubin</creatorcontrib><creatorcontrib>Shen, Weihua</creatorcontrib><creatorcontrib>Chen, Ying</creatorcontrib><creatorcontrib>Gan, Xiaoliang</creatorcontrib><creatorcontrib>Liu, Yizhi</creatorcontrib><creatorcontrib>Veyckemans, Francis</creatorcontrib><title>Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Summary
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.</description><subject>Administration, Intranasal</subject><subject>Administration, Oral</subject><subject>Cataract - congenital</subject><subject>Cataract - diagnosis</subject><subject>Child, Preschool</subject><subject>chloral hydrate</subject><subject>Chloral Hydrate - administration & dosage</subject><subject>Chloral Hydrate - adverse effects</subject><subject>Conscious Sedation - adverse effects</subject><subject>Conscious Sedation - methods</subject><subject>dexmedetomidine</subject><subject>Dexmedetomidine - administration & dosage</subject><subject>Dexmedetomidine - adverse effects</subject><subject>Eye</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - administration & dosage</subject><subject>Hypnotics and Sedatives - adverse effects</subject><subject>Hypoxemia</subject><subject>Infant</subject><subject>Male</subject><subject>ophthalmic examination</subject><subject>pediatric</subject><subject>Pediatrics</subject><subject>Physical Examination - methods</subject><subject>Quality</subject><subject>sedation</subject><subject>Treatment Outcome</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctKxDAUhoMo3he-gATc6KIzuTSdZCmDNxB1oeuSJqdMpE1q0kHn7Y0z6kIwm_NDPj4O50fohJIJzW86aD-hnJZyC-3TsiKFEopt50yFKERVij10kNIrIZSziu2iPSbLTCu1j-I89IOOLgWPQ4sTWD26nJsVdn6M2uukO2zhowcLY-iddR6w9haHmD_MolvPxcpGPQJuQ8QDWKfH6AwOw2Jc6K7PET507_zafYR2Wt0lOP6eh-jl-up5flvcP97czS_vC8MFl0XTKN4Qw_P6IEXVWkoNU5bMeMmEBcIqLtoZ1QwoaGV5Y1pr2cyalhvWSMoP0fnGO8TwtoQ01r1LBrpOewjLVFMpFZeMkyqjZ3_Q17CMPm-XKSU4oaKSmbrYUCaGlCK09RBdr-OqpqT-KqLORdTrIjJ7-m1cNvl0v-TP5TMw3QDvroPV_6b66fJho_wEf3qT7g</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Cao, Qianzhong</creator><creator>Lin, Yiquan</creator><creator>Xie, Zhubin</creator><creator>Shen, Weihua</creator><creator>Chen, Ying</creator><creator>Gan, Xiaoliang</creator><creator>Liu, Yizhi</creator><creator>Veyckemans, Francis</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8167-8272</orcidid></search><sort><creationdate>201706</creationdate><title>Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination</title><author>Cao, Qianzhong ; Lin, Yiquan ; Xie, Zhubin ; Shen, Weihua ; Chen, Ying ; Gan, Xiaoliang ; Liu, Yizhi ; Veyckemans, Francis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-bb93b0c3645e856fd11c29d073425de02635f71a2e1ea9d3bcfdd27dcf3c2b813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Administration, Intranasal</topic><topic>Administration, Oral</topic><topic>Cataract - congenital</topic><topic>Cataract - diagnosis</topic><topic>Child, Preschool</topic><topic>chloral hydrate</topic><topic>Chloral Hydrate - administration & dosage</topic><topic>Chloral Hydrate - adverse effects</topic><topic>Conscious Sedation - adverse effects</topic><topic>Conscious Sedation - methods</topic><topic>dexmedetomidine</topic><topic>Dexmedetomidine - administration & dosage</topic><topic>Dexmedetomidine - adverse effects</topic><topic>Eye</topic><topic>Female</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - administration & dosage</topic><topic>Hypnotics and Sedatives - adverse effects</topic><topic>Hypoxemia</topic><topic>Infant</topic><topic>Male</topic><topic>ophthalmic examination</topic><topic>pediatric</topic><topic>Pediatrics</topic><topic>Physical Examination - methods</topic><topic>Quality</topic><topic>sedation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cao, Qianzhong</creatorcontrib><creatorcontrib>Lin, Yiquan</creatorcontrib><creatorcontrib>Xie, Zhubin</creatorcontrib><creatorcontrib>Shen, Weihua</creatorcontrib><creatorcontrib>Chen, Ying</creatorcontrib><creatorcontrib>Gan, Xiaoliang</creatorcontrib><creatorcontrib>Liu, Yizhi</creatorcontrib><creatorcontrib>Veyckemans, Francis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cao, Qianzhong</au><au>Lin, Yiquan</au><au>Xie, Zhubin</au><au>Shen, Weihua</au><au>Chen, Ying</au><au>Gan, Xiaoliang</au><au>Liu, Yizhi</au><au>Veyckemans, Francis</au><au>Veyckemans, Francis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2017-06</date><risdate>2017</risdate><volume>27</volume><issue>6</issue><spage>629</spage><epage>636</epage><pages>629-636</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Summary
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.</abstract><cop>France</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28414899</pmid><doi>10.1111/pan.13148</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8167-8272</orcidid></addata></record> |
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| ispartof | Pediatric anesthesia, 2017-06, Vol.27 (6), p.629-636 |
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| subjects | Administration, Intranasal Administration, Oral Cataract - congenital Cataract - diagnosis Child, Preschool chloral hydrate Chloral Hydrate - administration & dosage Chloral Hydrate - adverse effects Conscious Sedation - adverse effects Conscious Sedation - methods dexmedetomidine Dexmedetomidine - administration & dosage Dexmedetomidine - adverse effects Eye Female Humans Hypnotics and Sedatives - administration & dosage Hypnotics and Sedatives - adverse effects Hypoxemia Infant Male ophthalmic examination pediatric Pediatrics Physical Examination - methods Quality sedation Treatment Outcome |
| title | Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination |
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