Oral Chloral Hydrate Compare with Rectal Thiopental in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial

Introduction: the increasing use of diagnostic imaging in pediatric medicine has resulted in growing need forprocedural sedation and analgesia (psa) to minimize motion artifacts during procedures. the drug of choice inpediatric psa was not introduced till now. the aim of the present study was comparison of oral chloral hydrate(och) and rectal sodium thiopental (rst) in pediatric psa.methods: in the present randomized clinical trial, 2?6 years old pediatrics who referred for performing braincomputed tomography scan was enrolled and were randomly divided in to two groups. och (50mg/kg) and rst(25mg/kg) were prescribed and a trained nurse recorded the time from drug prescription to receiving the conscioussedation (onset of action), the total time period which the patient has the ramsay score?4 (duration ofaction), and adverse effect of agents. mann?whitney u test and chi?squared test, and non?parametric analysis ofcovariance (ancova) were used for comparisons. results: one hundred and forty children were entered to twogroups of och and rst, randomly. the patients of two groups had similar age, sex, weight, and baseline vitalsigns except for diastolic blood pressure (p < 0.001). the onset of action in och and rst groups were 24.5±6.1and28.7±5.2 minutes, respectively (p < 0.001). duration of action in och and rst groups were 12.9±2.8 minutes and13.7±2.6 minutes, respectively (p=0.085). non parametric ancova revealed that only diastolic blood pressurewas affected by drug prescription (p=0.001). in 11(15.7%) patients in rst group, diarrhea was observed during24 hours (p=0.001). oxygen desaturation was observed only in two patients, both in och group. conclusion:each of the sedative has advantages and disadvantages that should be considered when selecting one for inducingshort?term sedation. it seems that rectal sodium thiopental and oral chloral hydrate are equally effective in pediatricpsa and based on patient’s condition we can administrate one of these agents.