CP-234 Is hydroxyzine–pentobarbital association efficient in paediatric sedation?. (25th February 2017)

• Record Type: Journal Article
• Authors: Mortier, CP; Frapsauce, A; Rucheton, A; Boivin, PN; Aubin, F
• Is Part Of: European journal of hospital pharmacy. Volume 24(2017)Supplement 1
• Page Start: A105
• Page End: A105
• Publication Date: 2017-02-25
• Subjects: Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2017-000640.232
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Background: Chloral hydrate, used as premedication for paediatric medical imaging, is available in France under Temporary Use Authorisation. Because of its potential carcinogenicity, its use is being restricted to a single administration per patient. Following this re-evaluation and in the absence of consensus, the alternative choice in our hospital is intra-rectal administration of pentobarbital (PTB). However, the efficacy of PTB alone is considered variable. Therefore, a protocol associating PTB with hydroxyzine 2 mg/kg (H-PTB) has been set up. Purpose: This study evaluated whether H-PTB association offered a significant improvement in paediatric medical imaging premedication compared with PTB alone. Material and methods: The efficacy of both premedication protocols was measured over 13 months, divided into two successive periods. During period 1, PTB was used. During period 2, H-PTB was used. The efficacy of premedication was evaluated regarding various criteria, such as the average time to fall asleep, procedure conditions, etc. Data were obtained during each procedure, using a paper grid that was then imported onto a spreadsheet for computer based analyses. Results: 120 patients were enrolled (period 1, 43; period 2, 77). Average age was 30 months in the H-PTB group versus 27 months in the PTB group. Average weight was identical in the two group and PTB was administered at the same dosage (4.6 mg/kg). The rate of falling asleep (96% vs 95%) and average lag time (66 vs 64 min) were identical. Absence of sleep or waking of the patient during installation was observed in 55% and 58% of patients, respectively. The rate of procedures successfully brought to an end was also equivalent in both groups. The average sleep duration was 61 min in the H-PTB group and 49 min in the PTB group. Conclusion: Contrary to our expectations, apart from the higher average sleep duration in the H-PTB group, sedation induced by H-PTB was similar to that of PTB on its own. The H-PTB association did not seem to improve paediatric imaging premedication in comparison with PTB alone. Regarding international guidelines, short half-life benzodiazepines seem to be suitable in this indication. Would benzodiazepine be an alternative to chloral hydrate? References and/or acknowledgements: Nice Guideline [CG112]. No conflict of interest