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Gholam Reza Zamani - One of the best experts on this subject based on the ideXlab platform.
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Clonidine Versus Chloral Hydrate for Recording Sleep EEG in Children
Iranian journal of child neurology, 2020Co-Authors: Mahmoud Reza Ashrafi, Hossein Mohebbi, Mahmoud Mohamadi, Elham Azizi, Gholam Reza Zamani, Ali Reza Tavasoli, Reza Shervin Badv, Firozeh HosseiniAbstract:Objective One of the difficulties for conduct electroencephalography (EEG) in pediatric patient population is that they are not always cooperative during the procedure. Different medications have been used to induce sedation during EEG recording. In order to find a medication with least adverse effects and high efficacy, we aimed to compare clonidine and Chloral hydrate as a premedication prior EEG performing in pediatric population. Materials & Methods A prospective, randomized, single-blinded, controlled trial was carried out over 198 children (9 to 156 months) to investigate the sedative and adverse effects of clonidine and Chloral hydrate. Patients, partially sleep-deprived the night before, were randomly divided in two groups of clonidine (100 patients) and Chloral hydrate (98 patients), on an alternative day basis. Results The average sleep onset latency was significantly longer in the clonidine group than Chloral hydrate group (Mann-Whitney test, p < 0.0001). Sleep duration ranged between 15-150 minutes and it was not significantly different between two groups (Mann-Whitney test p = 0.2). Drowsiness with Chloral hydrate terminated faster than with clonidine. Drowsiness after arousal was seen in 58% and 26.1% of patients in the clonidine and Chloral hydrate groups respectively that was significant (Mann-Whitney test, p = 0.058). EEG results were reported normal in 77 subjects in the Chloral hydrate group (77%) and in 69 subjects (69%) in the clonidine group (p = 0.161). Generalized epileptiform discharges reported significantly in the clonidine group (Mann-Whitney test , p = 0.006). Conclusion The results of this study showed that both Chloral hydrate 5% (one ml/kg)and clonidine (4 μg/kg)could be administered as a pre medication agent for EEG recording in children , although drowsiness after arousal of clonidine is greater than Chloral hydrate . However, the yield of generalized epileptiform discharges in the clonidine group was more than the Chloral hydrate group.
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sleep inducing for eeg recording in children a comparison between oral midazolam and Chloral hydrate
Iranian journal of child neurology, 2013Co-Authors: Mahmoud Reza Ashrafi, Gholam Reza Zamani, Reza Azizi Malamiri, Mahmoud Mohammadi, Firozeh HosseiniAbstract:Objective Electroencephalography (EEG) recording is a long duration procedure that needs patient’s cooperation for device setup and performing the procedure. Many children lose their cooperation during this procedure. Therefore, sedation and sleep are frequently induced using a few agents as pre procedure medication in children before EEG recording. We aimed to compare the sedative effects of oral midazolam versus Chloral hydrate before the procedure along with their impacts on EEG recording in children. Materials & Methods A randomized trial was carried out to compare the sedative effects of oral midazolam versus Chloral hydrate and their impacts on EEG recording in children. A total of 198 children (100 in the midazolam group and 98 in the Chloral hydrate group) were enrolled in the study and randomly allocated to receive either oral moidazolam or Chloral hydrate. Results Oral midazolam had superiority neither in sleep onset latency nor in sleep duration when compared to Chloral hydrate. Moreover, the yield of epileptiform discharges in the Chloral hydrate group was more than the midazolam group. Conclusion The results of this study showed that both Chloral hydrate 5% (one ml/kg) and oral midazolam (0.5 mg/kg) could be administered as a pre medication agent for EEG recording in children. However, oral midazolam at this dose had no advantage compared with Chloral hydrate.
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melatonin versus Chloral hydrate for recording sleep eeg
European Journal of Paediatric Neurology, 2010Co-Authors: Mahmoud Reza Ashrafi, Mahmoud Mohammadi, Javad Tafarroji, Reza Shabanian, Peyman Salamati, Gholam Reza ZamaniAbstract:Although behavioral training could be successful in promoting electroencephalogram (EEG) compliance without restraint or sedation, sleep EEG may increase the yield of seizure activity. Furthermore uncooperative children not amenable to behavioral training require sedation for EEG recording. Our aim was to assess the impact of melatonin on the sleep EEG recording in comparison with Chloral hydrate. Three hundred and forty eight patients (aged 1 month to 6 years) that were uncooperative with the EEG setup or referred for sleep EEG were enrolled in the study. Patients, partially sleep-deprived the night before, were randomly divided in two groups of melatonin and Chloral hydrate on an alternative day basis, 174 patients in each group. Sleep onset latency in the Chloral hydrate and melatonin groups was similar (Mann-Whitney test, P=0.113). However, sleep duration and drowsiness time were significantly shorter in the group of melatonin compared to the group of Chloral hydrate (Mann-Whitney test, P<0.0001 and P<0.0001 respectively). More patients in the melatonin group (20 versus six patients in the Chloral hydrate group) required a second dose of sedative for sleep induction (chi square test, P value=0.004). Seizure activities appeared in the electroencephalograms of 53% and 46% of patients in the melatonin and Chloral hydrate groups respectively that were significantly higher in the melatonin group (chi square test, P=0.005). Few adverse effects occurred in both groups (Fisher's exact test, P=0.64). The shorter sleep duration and drowsiness period were the two advantages of melatonin over Chloral hydrate. Furthermore higher yield of seizure activity detection in melatonin sedated patients was in favor of its prescription for sleep EEG recording in the pediatric population.
Mahmoud Reza Ashrafi - One of the best experts on this subject based on the ideXlab platform.
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Clonidine Versus Chloral Hydrate for Recording Sleep EEG in Children
Iranian journal of child neurology, 2020Co-Authors: Mahmoud Reza Ashrafi, Hossein Mohebbi, Mahmoud Mohamadi, Elham Azizi, Gholam Reza Zamani, Ali Reza Tavasoli, Reza Shervin Badv, Firozeh HosseiniAbstract:Objective One of the difficulties for conduct electroencephalography (EEG) in pediatric patient population is that they are not always cooperative during the procedure. Different medications have been used to induce sedation during EEG recording. In order to find a medication with least adverse effects and high efficacy, we aimed to compare clonidine and Chloral hydrate as a premedication prior EEG performing in pediatric population. Materials & Methods A prospective, randomized, single-blinded, controlled trial was carried out over 198 children (9 to 156 months) to investigate the sedative and adverse effects of clonidine and Chloral hydrate. Patients, partially sleep-deprived the night before, were randomly divided in two groups of clonidine (100 patients) and Chloral hydrate (98 patients), on an alternative day basis. Results The average sleep onset latency was significantly longer in the clonidine group than Chloral hydrate group (Mann-Whitney test, p < 0.0001). Sleep duration ranged between 15-150 minutes and it was not significantly different between two groups (Mann-Whitney test p = 0.2). Drowsiness with Chloral hydrate terminated faster than with clonidine. Drowsiness after arousal was seen in 58% and 26.1% of patients in the clonidine and Chloral hydrate groups respectively that was significant (Mann-Whitney test, p = 0.058). EEG results were reported normal in 77 subjects in the Chloral hydrate group (77%) and in 69 subjects (69%) in the clonidine group (p = 0.161). Generalized epileptiform discharges reported significantly in the clonidine group (Mann-Whitney test , p = 0.006). Conclusion The results of this study showed that both Chloral hydrate 5% (one ml/kg)and clonidine (4 μg/kg)could be administered as a pre medication agent for EEG recording in children , although drowsiness after arousal of clonidine is greater than Chloral hydrate . However, the yield of generalized epileptiform discharges in the clonidine group was more than the Chloral hydrate group.
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sleep inducing for eeg recording in children a comparison between oral midazolam and Chloral hydrate
Iranian journal of child neurology, 2013Co-Authors: Mahmoud Reza Ashrafi, Gholam Reza Zamani, Reza Azizi Malamiri, Mahmoud Mohammadi, Firozeh HosseiniAbstract:Objective Electroencephalography (EEG) recording is a long duration procedure that needs patient’s cooperation for device setup and performing the procedure. Many children lose their cooperation during this procedure. Therefore, sedation and sleep are frequently induced using a few agents as pre procedure medication in children before EEG recording. We aimed to compare the sedative effects of oral midazolam versus Chloral hydrate before the procedure along with their impacts on EEG recording in children. Materials & Methods A randomized trial was carried out to compare the sedative effects of oral midazolam versus Chloral hydrate and their impacts on EEG recording in children. A total of 198 children (100 in the midazolam group and 98 in the Chloral hydrate group) were enrolled in the study and randomly allocated to receive either oral moidazolam or Chloral hydrate. Results Oral midazolam had superiority neither in sleep onset latency nor in sleep duration when compared to Chloral hydrate. Moreover, the yield of epileptiform discharges in the Chloral hydrate group was more than the midazolam group. Conclusion The results of this study showed that both Chloral hydrate 5% (one ml/kg) and oral midazolam (0.5 mg/kg) could be administered as a pre medication agent for EEG recording in children. However, oral midazolam at this dose had no advantage compared with Chloral hydrate.
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melatonin versus Chloral hydrate for recording sleep eeg
European Journal of Paediatric Neurology, 2010Co-Authors: Mahmoud Reza Ashrafi, Mahmoud Mohammadi, Javad Tafarroji, Reza Shabanian, Peyman Salamati, Gholam Reza ZamaniAbstract:Although behavioral training could be successful in promoting electroencephalogram (EEG) compliance without restraint or sedation, sleep EEG may increase the yield of seizure activity. Furthermore uncooperative children not amenable to behavioral training require sedation for EEG recording. Our aim was to assess the impact of melatonin on the sleep EEG recording in comparison with Chloral hydrate. Three hundred and forty eight patients (aged 1 month to 6 years) that were uncooperative with the EEG setup or referred for sleep EEG were enrolled in the study. Patients, partially sleep-deprived the night before, were randomly divided in two groups of melatonin and Chloral hydrate on an alternative day basis, 174 patients in each group. Sleep onset latency in the Chloral hydrate and melatonin groups was similar (Mann-Whitney test, P=0.113). However, sleep duration and drowsiness time were significantly shorter in the group of melatonin compared to the group of Chloral hydrate (Mann-Whitney test, P<0.0001 and P<0.0001 respectively). More patients in the melatonin group (20 versus six patients in the Chloral hydrate group) required a second dose of sedative for sleep induction (chi square test, P value=0.004). Seizure activities appeared in the electroencephalograms of 53% and 46% of patients in the melatonin and Chloral hydrate groups respectively that were significantly higher in the melatonin group (chi square test, P=0.005). Few adverse effects occurred in both groups (Fisher's exact test, P=0.64). The shorter sleep duration and drowsiness period were the two advantages of melatonin over Chloral hydrate. Furthermore higher yield of seizure activity detection in melatonin sedated patients was in favor of its prescription for sleep EEG recording in the pediatric population.
Patricia E. Burrows - One of the best experts on this subject based on the ideXlab platform.
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superiority of pentobarbital versus Chloral hydrate for sedation in infants during imaging
Radiology, 2004Co-Authors: Keira P Mason, Pamela A Sanborn, Victoria E Karian, Paulette J Fontaine, Linda O'connor, David Zurakowski, Patricia E. BurrowsAbstract: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.
V M Yuen - One of the best experts on this subject based on the ideXlab platform.
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oral Chloral hydrate versus intranasal dexmedetomidine for sedation of children undergoing computed tomography a multicentre study
Hong Kong Medical Journal 25 (1(S3)) pp. 27-29. (2019), 2019Co-Authors: V M Yuen, Dkl Cheuk, T W C Hui, Ian C K Wong, W W M Lam, Michael G IrwinAbstract:1. Intranasal dexmedetomidine at 3 μg/kg can be used as primary sedative for young children during non-painful procedures. The rate of successful sedation is similar to that achieved by oral Chloral hydrate at 50 mg/kg. / 2. Intranasal dexmedetomidine is associated with better acceptance by young children compared with oral Chloral hydrate. / 3. Adverse effects of vomiting and gastrointestinal problems associated with Chloral hydrate sedation may be avoided with the use of intranasal dexmedetomidine. / 4. The time to resume normal activities after Chloral hydrate and dexmedetomidine sedation is similar.
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a randomized controlled trial of oral Chloral hydrate vs intranasal dexmedetomidine plus buccal midazolam for auditory brainstem response testing in children
Pediatric Anesthesia, 2018Co-Authors: V M Yuen, Jia L Zhou, Na Zhang, Jun X Huang, Hang Tian, Xing R SongAbstract:BACKGROUND Moderate to deep sedation is required for an auditory brainstem response test when high-intensity stimulation is used. Chloral hydrate is the most commonly used sedative, whereas intranasal dexmedetomidine is increasingly used in pediatric non-painful procedural sedations. OBJECTIVE The aim of this study was to compare the sedation success rate after oral Chloral hydrate at 50 mg kg-1 and intranasal dexmedetomidine at 3 μg kg-1 plus buccal midazolam at 0.1 mg kg-1 for an auditory brainstem response test. METHODS Children who required an auditory brainstem response test were recruited and randomly assigned to receive oral Chloral hydrate at 50 mg kg-1 and intranasal placebo, or intranasal dexmedetomidine at 3 μg kg-1 with buccal midazolam 0.1 mg kg-1 . The primary outcome was the rate of successful sedation for auditory brainstem response tests. RESULTS Fifty-seven out of 82 (69.5%) were successfully sedated after Chloral hydrate, while 70 out of 78 (89.7%) children were successfully sedated with dexmedetomidine plus midazolam combination, with the odd ratio (95% CI) for successful sedation between dexmedetomidine plus midazolam combination and Chloral hydrate estimated to be 3.84 (1.61-9.16), P = 0.002. Dexmedetomidine plus midazolam was associated with quicker onset with median onset time 15 (IQR 11.0-19.8) for dexmedetomidine plus midazolam and 20 (IQR 15.0-27.0) for Chloral hydrate respectively, with difference between median (95% CI) of 5 [3-8], P < 0.0001). The behavior observed during drug administration of intranasal dexmedetomidine and buccal midazolam was better that of the children who had oral Chloral hydrate. No children required oxygen therapy or medical intervention for hemodynamic disturbances in this study and the incidence of hypotension and bradycardia was similar. CONCLUSION Intranasal dexmedetomidine plus buccal midazolam was associated with higher sedation success with deeper level of sedation, with similar discharge time and adverse event rate when compared to Chloral hydrate.
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a randomised controlled trial of oral Chloral hydrate vs intranasal dexmedetomidine before computerised tomography in children
Anaesthesia, 2017Co-Authors: V M Yuen, Dkl Cheuk, T W C Hui, Ian C K Wong, W W M Lam, M K M Leung, S W Choi, Michael G IrwinAbstract:Chloral hydrate is commonly used to sedate children for painless procedures. Children may recover more quickly after sedation with dexmedetomidine, which has a shorter half-life. We randomly allocated 196 children to Chloral hydrate syrup 50 mg.kg-1 and intranasal saline spray, or placebo syrup and intranasal dexmedetomidine spray 3 μg.kg-1 , 30 min before computerised tomography studies. More children resisted or cried after drinking Chloral hydrate syrup than placebo syrup, 72 of 107 (67%) vs. 42 of 87 (48%), p = 0.009, but there was no difference after intranasal saline vs. dexmedetomidine, 49 of 107 (46%) vs. 40 of 87 (46%), p = 0.98. Sedation was satisfactory in 81 of 107 (76%) children after Chloral hydrate and 64 of 87 (74%) children after dexmedetomidine, p = 0.74. Of the 173 children followed up for at least 4 h after discharge, 38 of 97 (39%) had recovered normal function after Chloral hydrate and 32 of 76 (42%) after dexmedetomidine, p = 0.76. Six children vomited after Chloral hydrate syrup and placebo spray vs. none after placebo syrup and dexmedetomidine spray, p = 0.03.
Mahmoud Mohammadi - One of the best experts on this subject based on the ideXlab platform.
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sleep inducing for eeg recording in children a comparison between oral midazolam and Chloral hydrate
Iranian journal of child neurology, 2013Co-Authors: Mahmoud Reza Ashrafi, Gholam Reza Zamani, Reza Azizi Malamiri, Mahmoud Mohammadi, Firozeh HosseiniAbstract:Objective Electroencephalography (EEG) recording is a long duration procedure that needs patient’s cooperation for device setup and performing the procedure. Many children lose their cooperation during this procedure. Therefore, sedation and sleep are frequently induced using a few agents as pre procedure medication in children before EEG recording. We aimed to compare the sedative effects of oral midazolam versus Chloral hydrate before the procedure along with their impacts on EEG recording in children. Materials & Methods A randomized trial was carried out to compare the sedative effects of oral midazolam versus Chloral hydrate and their impacts on EEG recording in children. A total of 198 children (100 in the midazolam group and 98 in the Chloral hydrate group) were enrolled in the study and randomly allocated to receive either oral moidazolam or Chloral hydrate. Results Oral midazolam had superiority neither in sleep onset latency nor in sleep duration when compared to Chloral hydrate. Moreover, the yield of epileptiform discharges in the Chloral hydrate group was more than the midazolam group. Conclusion The results of this study showed that both Chloral hydrate 5% (one ml/kg) and oral midazolam (0.5 mg/kg) could be administered as a pre medication agent for EEG recording in children. However, oral midazolam at this dose had no advantage compared with Chloral hydrate.
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melatonin versus Chloral hydrate for recording sleep eeg
European Journal of Paediatric Neurology, 2010Co-Authors: Mahmoud Reza Ashrafi, Mahmoud Mohammadi, Javad Tafarroji, Reza Shabanian, Peyman Salamati, Gholam Reza ZamaniAbstract:Although behavioral training could be successful in promoting electroencephalogram (EEG) compliance without restraint or sedation, sleep EEG may increase the yield of seizure activity. Furthermore uncooperative children not amenable to behavioral training require sedation for EEG recording. Our aim was to assess the impact of melatonin on the sleep EEG recording in comparison with Chloral hydrate. Three hundred and forty eight patients (aged 1 month to 6 years) that were uncooperative with the EEG setup or referred for sleep EEG were enrolled in the study. Patients, partially sleep-deprived the night before, were randomly divided in two groups of melatonin and Chloral hydrate on an alternative day basis, 174 patients in each group. Sleep onset latency in the Chloral hydrate and melatonin groups was similar (Mann-Whitney test, P=0.113). However, sleep duration and drowsiness time were significantly shorter in the group of melatonin compared to the group of Chloral hydrate (Mann-Whitney test, P<0.0001 and P<0.0001 respectively). More patients in the melatonin group (20 versus six patients in the Chloral hydrate group) required a second dose of sedative for sleep induction (chi square test, P value=0.004). Seizure activities appeared in the electroencephalograms of 53% and 46% of patients in the melatonin and Chloral hydrate groups respectively that were significantly higher in the melatonin group (chi square test, P=0.005). Few adverse effects occurred in both groups (Fisher's exact test, P=0.64). The shorter sleep duration and drowsiness period were the two advantages of melatonin over Chloral hydrate. Furthermore higher yield of seizure activity detection in melatonin sedated patients was in favor of its prescription for sleep EEG recording in the pediatric population.