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Superiority of Pentobarbital versus Chloral Hydrate for Sedation in Infants during Imaging¹

¹ From the Departments of Anesthesia (K.P.M.), Radiology (K.P.M., P.S., V.E.K., L.C., P.J.F., P.E.B.), Biostatistics (D.Z.), and Orthopaedic Surgery (D.Z.), Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115. Received January 17, 2003; revision requested March 3; final revision received June 23; accepted July 31. Address correspondence to K.P.M. (e-mail: keira.mason@tch.harvard.edu).

PURPOSE: To compare the effectiveness and safety of oral pentobarbital and oral chloral hydrate for sedation in infants younger than 1 year during magnetic resonance (MR) imaging and computed tomography (CT).

MATERIALS AND METHODS: A computerized database was used to collect information about all cases in which sedation was used. Outcomes of all infants who received oral pentobarbital or oral chloral hydrate for sedation between 1997 and 2002 were reviewed. Two study groups were compared for sedation and discharge times by using Student t test and for adverse events by using Fisher exact test and multiple logistic regression analysis.

RESULTS: Infants (n = 1,316) received an oral medication for sedation. Mean doses were 50 mg/kg chloral hydrate and 4 mg/kg pentobarbital. Student t test demonstrated no difference in mean time to sedation and in time to discharge between groups. Overall adverse event rate during sedation was lower with pentobarbital (0.5%) than with chloral hydrate (2.7%) (P < .001). There were fewer episodes of oxygen desaturation with pentobarbital (0.2%) than with chloral hydrate (1.6%) (P < .01). Both medications were equally effective in providing successful sedation.

CONCLUSION: Although oral pentobarbital and oral chloral hydrate are equally effective, the incidence of adverse events with pentobarbital was significantly reduced.

© RSNA, 2003

Index terms: Anesthesia • Computed tomography (CT), in infants and children • Magnetic resonance (MR), in infants and children

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